Podcasts about Ihi

The Federal Communications Commission (FCC) is looking to significantly expand satellite spectrum assets across multiple bands for current and next-generation space-based broadband connectivity. The Federal Aviation Authority (FAA) has authorized Starship to return to flight. Impulse Space and SES have signed a multi-launch agreement, and more. Remember to leave us a 5-star rating and review in your favorite podcast app. Be sure to follow T-Minus on LinkedIn and Instagram. T-Minus Guest NASASpaceflight.com brings us the Space Traffic Report. Selected Reading FCC Looks to Unleash 20,000 Megahertz for Satellite Spectrum Abundance FAA General Statements- Federal Aviation Administration SES Signs Multi-Launch Agreement for Helios Transport Services with Impulse Space ICEYE and IHI start cooperation to develop SAR satellite constellation in Japan $20.7 million approved by Texas Space Commission for SEARF grant awards Chinese astronauts add debris shields to Tiangong space station during 8-hour spacewalk (video) NASA Signs Agreement with Argentina's Space Agency for Artemis II CubeSat Astrobotic Lunar Wireless Charger System Qualified for Flight Best model rocket sets 2025: NASA, Blue Origin, Estes, National Geographic and more Want to hear your company in the show? You too can reach the most influential leaders and operators in the industry. Here's our media kit. Contact us at space@n2k.com to request more info. Want to join us for an interview? Please send your pitch to space-editor@n2k.com and include your name, affiliation, and topic proposal. T-Minus is a production of N2K Networks, your source for strategic workforce intelligence. © N2K Networks, Inc. Learn more about your ad choices. Visit megaphone.fm/adchoices

Could primary care at home unlock better health and lower costs for American families? Rebekah Gee, a physician and policymaker turned entrepreneur, joins us to talk about the big bet her company Nest Health is making on home-based primary care. It's a model that makes sense for families and delivers results. In the first year of operations Nest doubled primary care visits, reduced ER visits, and increased childhood immunizations.We discuss:The sound economics behind the Medicaid expansion in LouisianaWhat she learned from her mentor, astronaut John GlennHow to close the primary care gap for children and parents Whether ultra processed foods are the next tobaccoRebekah shared about an exchange with Elon Musk on the short sightedness of Medicaid cuts:“So Nest came out with our savings numbers. We put out some really good information about the health of children and the opportunities. And Elon Musk retweeted it. So as a result of that, we actually got a lot of press. But I wrote back to him and said, ‘I'm glad you like this concept. And just remember, don't cut health care for children because we'll be paying far more for that than you will ever save.' ”Relevant LinksRead more about Nest HealthWatch: Dr. Rebekah Gee on what entrepreneurs need to know about MedicaidLearn about Alaska's Nuka system of careEvidence from the Nurse Family Partnership about the impact of home-based careAbout Our GuestDr. Rebekah Gee is the founder and CEO of Nest Health, a technology-enabled whole-family primary care provider providing care at home and virtually to Americans who struggle to receive comprehensive care. Previously, Dr. Gee served as Secretary of Health for the State of Louisiana. In that cabinet-level role, she led the expansion of Medicaid. As Secretary, she was responsible for nearly half the state budget including Medicaid, public health, aging and adult services, licensure, sanitation, disability services, and a nearly 2,000 bed state hospital system. As Secretary, she developed a first-in-the-nation subscription model for the drugs that cure Hepatitis C that is being used as a national and international model for increased drug access and affordability.Dr. Gee has served as an advisor to multiple Governors, presidential campaigns, and policy efforts at the state and national level. Her board service includes medical advisory support of public companies Select Quote and 3D systems. She has also served as a board member or advisor to Ready Responders, Ouva, Noble, NCQA, NQF, IHI, the Penn Center for Behavioral Economics, and the Duke-Margolis Institute.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedInSubscribe to The Other 80 on YouTube so you never miss our video extras or special video...

防衛産業はなぜ“儲かる”ようになったのか？　重工3社に見る変化の本質。　IHI、三菱重工業（以下、三菱重工）、川崎重工業（以下、川崎重工）といった、いわゆる「重工3社」の株価がこの1年で大きく上昇しています。

豊洲エリアの再開発、街区名称は「豊洲セイルパーク」に決定　今夏に開業へ。　三菱地所とIHIは2月21日、再開発を進めている豊洲二・三丁目地区の街区名を「豊洲セイルパーク（TOYOSU SAIL PARK）」に決定したと発表した。同エリアにおける最後の大規模再開発で、竣工は6月、開業は今夏を予定している。

Japan's space agency says it successfully launched a navigation satellite on its new H3 rocket. The latest launch on February 2 took place as the country aims to develop a more precise positioning system. 日本航天局表示，它成功地在其新的H3火箭上推出了导航卫星。2月2日的最新发布会是该国旨在开发更精确的定位系统的。 The H3 rocket carrying the Michibiki 6 satellite lifted off from the Tanegashima Space Center on a southwestern Japanese island. 载有Michibiki 6卫星的H3火箭从日本西南部的Tanegashima太空中心抬起。 Makoto Arita oversees the H3 project for the Japan Aerospace Exploration Agency known as JAXA. Arita said everything went smoothly and the satellite successfully separated from the rocket as planned about 29 minutes after liftoff.Makoto Arita监督日本航空航天勘探局的H3项目，称为Jaxa。阿里塔（Arita）说，一切都顺利进行，卫星在升空后约29分钟后成功地与火箭分离。 Officials said it should reach its target orbit around Earth in the middle of February. 官员说，它应该在2月中旬到达地球周围的目标轨道。 Japan's current system is called the quasi-zenith satellite system, or QZSS. It started operating in 2018 and has four satellites that serve a regional navigation system. The Michibiki 6 will be the fifth satellite in the network. 日本当前的系统称为准Zenith卫星系统或QZSS。它从2018年开始运行，并拥有四个为区域导航系统服务的卫星。Michibiki 6将是网络中的第五颗卫星。 Michibiki's signals are used to supplement the American satellite system called the Global Positioning System (GPS). It will also improve positioning data for smartphones, car navigation, navigation at sea and drones. Michibiki的信号用于补充称为全球定位系统（GPS）的美国卫星系统。它还将改善智能手机，汽车导航，海上航行和无人机的定位数据。 Japan plans to launch two more navigation satellites to have a seven-satellite system by March 2026. The Japan Science and Technology Agency hopes that will create a more precise global positioning ability without depending on foreign services, including GPS. By the late 2030s, Japan plans to have an 11-satellite network. 日本计划在2026年3月之前发射另外两条导航卫星，以建立七个卫星系统。日本科学技术局希望，它将创造更精确的全球定位能力，而不会依赖包括外国服务（包括GPS）。到2030年代后期，日本计划拥有一个11卫星网络。Sunday's launch was the fourth successful flight in a row for the H3 system. The first attempt to launch last year failed and the rocket had to be destroyed with its payload. 周日的发布是H3系统连续第四次成功的航班。去年发射的首次尝试失败了，火箭必须用有效载荷摧毁。 Japan considers the ability to regularly put satellites into orbit as important to its space program and national security. It has been developing two new leading rockets. One is the large H3 from Mitsubishi Heavy Industries. The other is a much smaller Epsilon system with the aerospace unit of IHI corporation. Japan hopes to meet the needs of companies for space launch services and improve its position in the growing satellite launch market. 日本认为能够定期将卫星放入轨道上对其太空计划和国家安全至关重要。它一直在开发两个新的领先火箭。一个是来自三菱重工业的大型H3。另一个是IHI Corporation的航空航天单元的一个小得多的Epsilon系统。日本希望满足公司对太空发射服务的需求，并提高其在不断增长的卫星发射市场中的地位。

Hypnosomatic Therapy Featuring Erik Burns In this episode of the Feeling Good podcast, we hear from another David Burns—not me (David Dean Burns), but rather David Erik Burns, my wonderful and beloved son. Erik discusses his journey in creating BloomHarmony.org, his new clinical practice that integrates hypnotherapy with somatic work. To kick things off, Erik shares personal stories about his relationship with his father, David, including the story of his birth and struggle to breathe in the pediatric intensive care unit, and how touch has played a significant role in his life and healing journey. He emphasizes the idea that words alone sometimes fall short in attempts to convey love or transmit healing. A loving touch, in contrast, can make an immediate and profound impact. Today's conversation delves into the mind-body connection and the importance of emotional expression in therapy. Erik calls his innovative approach hypnosomatic healing, which involves a combination of guided hypnotic imagery with massage.  The mind/body connection refers to the dynamic relationship between your thoughts, emotions, beliefs, and attitudes (the mind), and your physical health and bodily functions (the body). Erik emphasizes the transformative power of touch and the need for openness in therapeutic settings, exploring how these elements can lead to a profound healing experience. Erik also discusses the tremendous value of longer therapy sessions as well as the powerful role of trance states in therapy and in life. They also discuss the ethical balance between therapist livelihood (which naturally requires charging for sessions) and the therapist's genuine commitment to the relief of suffering, regardless of the patient's financial resources. Both Erik and his dad, David Sr., agree that in an ideal world, health care would be free and available to all, and regret having to charge for treatment. Erik always takes the needs of his clients into account and works for a reduced fee or for free if needed. Erik explains how and why the mind-body connection is so crucial to genuine healing and describes the importance of energy management during sessions Here's how he explains it: Energy management is about showing up with the proper state of consciousness for a session. Transpersonal work relies heavily on the therapist interpersonal relationship, so the state I am in has a huge influence on the outcome. We teach a 3-sided model: emptiness, awareness, and love. "Energy" management would be the preparation I do to both Empty myself from pre-conceived notions (AKA getting out of my own way), to step into observer consciousness, and to become rooted in love. I guess a simpler way to describe energy management would be to become an open unconditional channel and to silence the monkey mind as much as possible. I believe I may have been referring to the inner child dialog I often do before a session to help achieve this state. The dialogue also explores the transformative experiences clients can undergo in therapy and the tools therapists can use to empower clients who feel helpless, hopeless, or defeated. The personal connection between therapists and clients is highlighted as a crucial element in the healing process. While gut problems, such as irritable bowel and chronic abdominal complaints are important targets for hypnosomatic therapy, Erik emphasizes the potential value of his approach for a wide variety of complaints, including Emotional problems Depression, grief, despair Loss of motivation, pleasure or satisfaction in life Anxiety / stress / worry / panic / fear Recent or past trauma Feelings of inadequacy, inferiority, worthlessness Feelings of hopelessness, discouragement, and frustration Interpersonal difficulties Anger Relationship conflicts Loneliness Feeling isolated, unlovable, unloved Blame, bitterness and resentment Physical / somatic complaints Chronic belly pain, back pain, chest pain, headache, etc. Chronic fatigue / exhaustion / burn out Dizziness Spiritual Feeling empty, rudderless and lost Wondering, “Who am I?” Wondering, “What's the meaning and purpose of my life?” Wondering, “Why am I struggling and suffering?” Here  are Erik's actual words, from his website, BloomHarmon.org: I Hi, I'm Erik. I believe in your potential to live a pain-free, vibrant life. Why do I believe in you? Pain relief is not just my profession — it's also my personal journey. I've lived with gut disorders for most of my life, including food allergies to wheat and milk, intermittent pain, and ulcers. I sought help from Western doctors but never received much relief. Modifying my diet provided some improvement, but it never fully addressed the underlying issues. Finally, I discovered hypnotherapy, and my life really started to change. As an undergraduate at Stanford University, I studied neurophysiology and  deepened my understanding of the mind-body connection. I also trained in deep tissue and polarity massage, which showed me how treating the mind and body together can maximize the effects of each approach. This holistic understanding led me to develop my primary modality, hypnosomatics, a comprehensive body care treatment that combines elements of massage and hypnotherapy to supercharge recovery. A lot of research has been done into the underlying causes of chronic gut pain. Conditions like IBS, SIBO, and GERD have been studied extensively. Gut-directed hypnotherapy (GDH) is widely considered the most medically effective form of treatment for these types of conditions, with treatment success rates often exceeding 70-80%. This discovery was transformative for me, and it can be for you too. Today, I am mostly pain-free and thriving, and I want to share the tools and techniques that were so helpful for me. My approach to well-being goes beyond reducing pain; it's about empowering you to transform your own life from within and, ultimately, to thrive. Thank you for listening today! Erik, Rhonda, and David

O keia o Ihi, ka'u keiki kane mua loa. 6 ona makahiki. Nui kona hoihoi i ka paani Minecraft i keia manawa. A paani mau oia i kela ma ka Ninetendo Switch. E hoolohe mai i kana hahai moolelo ana e pili ana i na ano mea like ole o kela paani.

Join host Andrew Stotz for a lively conversation with Cliff Norman and Dave Williams, two of the authors of "Quality as an Organizational Strategy." They share stories of Dr. Deming, insights from working with businesses over the years, and the five activities the book is based on. TRANSCRIPT 0:00:02.2 Andrew Stotz: My name is Andrew Stotz, and I'll be your host as we dive deeper into the teachings of Dr. W. Edwards Deming. Today, we have a fantastic opportunity to learn more about a recent book that's been published called "Quality as an Organizational Strategy". And I'd like to welcome Cliff Norman and Dave Williams on the show, two of the three authors. Welcome, guys.   0:00:27.1 Cliff Norman: Thank you. Glad to be here.   0:00:29.4 Dave Williams: Yeah, thanks for having us.   0:00:31.9 Andrew Stotz: Yeah, I've been looking forward to this for a while. I was on LinkedIn originally, and somebody posted it. I don't remember who, the book came out. And I immediately ordered it because I thought to myself, wait, wait, wait a minute. This plugs a gap. And I just wanna start off by going back to Dr. Deming's first Point, which was create constancy of purpose towards improvement of product and service with the aim to become competitive and stay in business and to provide jobs. And all along, as anybody that learned the 14 Points, they knew that this was the concept of the strategy is to continue to improve the product and service in the eyes of the client and in your business. But there was a lot missing. And I felt like your book has started really to fill that gap. So maybe I'll ask Cliff, if you could just explain kind of where does this book come from and why are you bringing it out now?   0:01:34.5 Cliff Norman: That's a really good question, Andrew. The book was originally for the use of both our clients only. So it came into being, the ideas came out of the Deming four day seminar where Dr. Tom Nolan, Ron Moen and Lloyd Provost, Jerry Langley would be working with Dr. Deming. And then at the end of four days, the people who some of who are our clients would come up to us and said, he gave us the theory, but we don't have any methods. And so they took it very seriously and took Dr. Deming's idea of production viewed as a system. And from that, they developed the methods that we're going to discuss called the five activities. And all of our work with this was completely behind the wall of our clients. We didn't advertise. So the only people who became clients were people who would seek us out. So this has been behind the stage since about 1990. And the reason to bring it out now is to make it available beyond our client base. And Dave, I want you to go ahead and add to that because you're the ones that insisted that this get done. So add to that if you would.   [laughter]   0:02:53.0 Dave Williams: Well, thanks, Cliff. Actually, I often joke at Cliff. So one thing to know, Cliff and Lloyd and I all had a home base of Austin, Texas. And I met them about 15 years ago when I was in my own journey of, I had been a chief quality officer of an ambulance system and was interested in much of the work that API, Associates of Process Improvement, had been doing with folks in the healthcare sector. And I reached out to Cliff and Lloyd because they were in Austin and they were kind enough, as they have been over many years, to welcome me to have coffee and talk about what I was trying to learn and where my interests were and to learn from their work. And over the last 15 years, I've had a great benefit of learning from the experience and methods that API has been using with organizations around the world, built on the shoulders of the theories from Dr. Deming. And one of those that was in the Improvement Guide, one of the foundational texts that we use a lot in improvement project work that API wrote was, if you go into the back, there is a chapter, and Cliff, correct me if I'm wrong, I think it's chapter 13 in this current edition on creating value.   0:04:34.3 Dave Williams: In there, there was some description of kind of a structure or a system of activities that would be used to pursue qualities and organizational strategy. I later learned that this was built on a guide that was used that had been sort of semi self-published to be able to use with clients. And the more that I dove into it, the more that I really valued the way in which it had been framed, but also how, as you mentioned at the start, it provided methods in a place where I felt like there was a gap in what I saw in organizations that I was working with or that I had been involved in. And so back in 2020, when things were shut down initially during the beginning of the pandemic, I approached Lloyd and Cliff and I said, I'd love to help in any way that I can to try to bring this work forward and modernize it. And I say modernize it, not necessarily in terms of changing it, but updating the material from its last update into today's context and examples and make it available for folks through traditional bookstores and other venues.   0:05:58.9 Andrew Stotz: And I have that The Improvement Guide, which is also a very impressive book that helps us to think about how are we improving. And as you said, the, that chapter that you were talking about, 13, I believe it was, yeah, making the improvement of value a business strategy and talking about that. So, Cliff, could you just go back in time for those people that don't know you in the Deming world, I'm sure most people do, but for those people that don't know, maybe you could just talk about your first interactions with Dr. Deming and the teachings of that and what sparked your interest and also what made you think, okay, I wanna keep expanding on this.   0:06:40.0 Cliff Norman: Yeah. So I was raised in Southern California and of course, like many others, I'm rather horrified by what's going on out there right now with fires. That's an area I was raised in. And so I moved to Texas in '79, went to work for Halliburton. And they had an NBC White Paper called, "If Japan Can, Why Can't We?", and our CEO, Mr. Purvis Thrash, he saw that. And I was working in the quality area at that time. And he asked me to go to one of Deming's seminars that was held in Crystal City, actually February of 1982. And I got down there early and got a place up front. And they sent along with me an RD manager to keep an eye on me, 'cause I was newly from California into Texas. And so anyway, we're both sitting there. And so I forgot something. So I ran up stairs in the Sheraton Crystal City Hotel there. And I was coming down and lo and behold, next floor down, Dr. Deming gets on and two ladies are holding him up. And they get in the elevator there and he sees this George Washington University badge and he kind of comes over, even while the elevator was going down and picks it up and looks it up real close to his face. And then he just backs up and leans, holds onto the railing and he says, Mr. Norman, what I'm getting ready to tell you today will haunt you for the rest of your life.   0:08:11.8 Cliff Norman: And that came true. And of course, I was 29 at the time and was a certified quality engineer and knew all things about the science of quality. And I couldn't imagine what he would tell me that would haunt me for the rest of my life, but it did. And then the next thing he told me, he said, as young as you are, if you're not learning from somebody that you're working for, you ought to think about getting a new boss. And that's some of the best advice I've ever gotten. I mean, the hanging around smart people is a great thing to do. And I've been gifted with that with API. And so that's how I met him. And then, of course, when I joined API, I ended up going to several seminars to support Lloyd Provost and Tom Nolan and Ron Moen and Jerry as the various seminars were given. And Ron Moen, who unfortunately passed away about three years ago, he did 88 of those four day seminars, and he was just like a walking encyclopedia for me. So anytime I had questions on Deming, I could just, he's a phone call away, and I truly miss that right now.   0:09:20.5 Cliff Norman: So when Dave has questions or where this reference come from or whatever, and I got to go do a lot of work, where Ron, he could just recall that for me. So I miss that desperately, but we were busy at that time, by the time I joined API was in '88. And right away, I was introduced to what they had drafted out in terms of the five activities, which is the foundation of the book, along with understanding the science of improvement and the chain reaction that Dr. Deming introduced us to. So the science of improvement is what Dr. Deming called the System of Profound Knowledge. So I was already introduced to all that and was applying that within Halliburton. But QBS, as we called it then, Qualities of Business Strategy was brand new. I mean, it was hot off the press. And right away, I took it and started working with my clients with it. And we were literally walking on the bridge as we were building it. And the lady I'm married to right now, Jane Norman, she was working at Conagra, which is like a $15 billion poultry company that's part of Conagra overall, which is most of the food in your grocery store, about 75% of it. And she did one of the first system linkages that we ever did.   0:10:44.5 Cliff Norman: And since then, she's worked at like four other companies as a VP or COO, and has always applied these ideas. And so a lot of this in the book examples and so forth, comes from her actual application work. And when we'd worked together, she had often introduced me, this is my husband, Cliff, he and his partners, they write books, but some of us actually have to go to work. And then eventually she wrote a book with me with Dr. Maccabee, who is also very closely associated with Dr. Deming. So now she's a co-author. So I was hoping that would stop that, but again, we depend on her for a lot of the examples and contributions and the rest of it that show up in the book. So I hope that answers your question.   0:11:28.2 Andrew Stotz: Yeah, and for people like myself and some of our listeners who have heard Dr. Deming speak and really gotten into his teachings, it makes sense, this is going to haunt you because I always say that, what I read originally... I was 24 when I went to my first Deming seminar. And I went to two two-day seminars and it... My brain was open, I was ready, I didn't have anything really in it about, any fixed methods or anything. So, for me, it just blew my mind, some of the things that he was talking about, like thinking about things in a system I didn't think about that I thought that the way we got to do is narrow things down and get this really tight focus and many other things that I heard. And also as a young, young guy, I was in this room with, I don't know, 500 older gentlemen and ladies, and I sat in the front row and so I would see him kind of call them on the carpet and I would be looking back like, oh, wow, I never saw anybody talk to senior management like that and I was kind of surprised. But for those people that really haven't had any of that experience they're new to Deming, what is it that haunts you? What is... Can you describe what he meant when he was saying that?   0:12:42.9 Cliff Norman: I gotta just add to what you just said because it's such a profound experience. And when you're 29, if most of us, we think we're pretty good shape by that time, the brain's fully developed by age 25, judgment being the last function that develops. And so you're pretty well on your way and then to walk in and have somebody who's 81 years old, start introducing you to things you've never even thought about. The idea of the Chain Reaction that what I was taught as a certified quality engineer through ASQ is I need to do enough inspection, but I didn't need to do too much 'cause I didn't want to raise costs too much. And Dr. Deming brought me up on stage and he said, well, show me that card again. So I had a 105D card, it's up to G now or something. And he said, "well, how does this work?" And I said, "well, it tells me how many samples I got to get." And he says, "you know who invented that." And I said, "no, sir, I thought God did." He said, "no, I know the people that did it. They did it to put people like you out of business. Sit down, young man, you've got a lot to learn." And I thought, wow, and here you are in front of 500 people and this is a public flogging by any stretch.   0:13:56.1 Cliff Norman: And it just went on from there. And so a few years later, I'm up in Valley Forge and I'm working at a class with Lloyd and Tom Nolan and a guy named, I never met before named Jim Imboden. And he's just knock-down brilliant, but they're all working at General Motors at that time. And a lot of the book "Planned Experimentation" came out of their work at Ford and GM and Pontiac and the rest of it. And I mean, it's just an amazing contribution, but I go to dinner with Jim that night. And Jim looks at me across the table and he says, Cliff, how did you feel the day you found out you didn't know anything about business economics or anything else? I said, "you mean the first day of the Deming seminar?" He said, "that's what I'm talking about." And that just... That's how profound that experience is. Because all of a sudden you find out you can improve quality and lower costs at the same time. I'm sorry, most people weren't taught that. They certainly weren't taught that in business school. And so it was a whole transformation in thinking and just the idea of a system. Most of what's going on in the system is related to the system and the way it's constructed. And unfortunately, for most organizations, it's hidden.   0:15:04.2 Cliff Norman: They don't even see it. So when things happen, the first thing that happens is the blame flame. I had a VP I worked for and he'd pulled out his org chart when something went bad and he'd circle. He said, this is old Earl's bailiwick right here. So Cliff, go over and see Earl and I want you to straighten him out. Well, that's how most of it runs. And so the blame flame just takes off. And if you pull the systems map out there and if he had to circle where it showed up, he'd see there were a lot of friends around that that were contributing. And we start to understand the complexity of the issue. But without that view, and Deming insisted on, then you're back to the blame flame.   0:15:45.1 Andrew Stotz: Yeah. And Dave, I see a lot of books on the back on your shelf there about quality and productivity and team and many different things. But maybe you could give us a little background on kind of how how you, besides how you got onto this project and all that. But just where did you come from originally and how did you stumble into the Deming world?   0:16:08.9 Dave Williams: Sure. Well, sadly, I didn't have the pleasure of getting to sit in on a four-day workshop. Deming died in 1993. And at that time, I was working on an ambulance as a street paramedic and going to college to study ambulance system design and how to manage ambulance systems, which was a part of public safety that had sort of grown, especially in the United States in the '60s. And by the time I was joining, it was about 30 years into becoming more of a formalized profession. And I found my way to Austin, Texas, trying to find one of the more professionalized systems to work in and was, worked here as a paramedic for a few years. And then decided I wanted to learn more and started a graduate program. And one of the courses that was taught in the graduate program, this is a graduate program on ambulance management, was on quality. And it was taught by a gentleman who had written a, a guide for ambulance leaders in the United States that was based on the principles and methods of quality that was happening at this time. And it pieced together a number of different common tools and methods like Pareto charts and cause-and-effect diagrams and things like that.   0:17:33.1 Dave Williams: And it mentioned the different leaders like Deming and Juran and Crosby and others. And so that was my first exposure to many of these ideas. And because I was studying a particular type of healthcare delivery system and I was a person who was practicing within it and I was learning about these ideas that the way that you improve a system or make improvement is by changing the system. I was really intrigued and it just worked out at the time. One of the first roles, leadership roles that emerged in my organization was to be the Chief Quality Officer for the organization. And at the time, there were 20 applicants within my organization, but I was the only one that knew anything about any of the foundations of quality improvements. Everybody else applied and showed their understanding of quality from a lived experience perspective or what their own personal definitions of quality were, which was mostly around inspection and quality assurance. I had, and this won't surprise Cliff, but I had a nerdy response that was loaded with references and came from all these different things that I had been exposed to. And they took a chance on me because I was the only one that seemed to have some sense of the background. And I started working and doing...   0:19:10.1 Dave Williams: Improvement within this ambulance system as the kind of the dedicated leader who was supposed to make these changes. And I think one of the things that I learned really quickly is that frequently how improvement efforts were brought to my attention was because there was a problem that I, had been identified, a failure or an error usually attributed to an individual as Cliff pointed out, somebody did something and they were the unfortunate person who happened to kind of raise this issue to others. And if I investigated it all, I often found that there were 20 other people that made the same error, but he was, he or she was the only one that got caught. And so therefore they were called to my office to confess. And when I started to study and look at these different issues, every time I looked at something even though I might be able to attribute the, first instance to a person, I found 20 or more instances where the system would've allowed or did allow somebody else to make a similar error.   0:20:12.6 Dave Williams: We just didn't find it. And it got... And it became somewhat fascinating to me because my colleagues were very much from a, if you work hard and just do your job and just follow the policy then good quality will occur. And nobody seemed to spend any time trying to figure out how to create systems that produce good results or figure out how to look at a system and change it and get better results. And so most of my experience was coming from these, when something bubbled up, I would then get it, and then I'd use some systems thinking and some methods and all of a sudden unpack that there was a lot of variation going on and a lot of errors that could happen, and that the system was built to get results worse than we even knew.   0:21:00.7 Dave Williams: And it was through that journey that I ended up actually becoming involved with the Institute for Healthcare Improvement and learning about what was being done in the healthcare sector, which API at the time were the key advisors to Dr. Don Berwick and the leadership at IHI. And so much of the methodology was there. And actually, that's how I found my way to Cliff. I happened to be at a conference for the Institute for Healthcare Improvement, and there was an advertisement for a program called the Improvement Advisor Professional Development Program, which was an improvement like practitioner project level program that had been developed by API that had been adapted to IHI, and I noticed that Cliff and Lloyd were the faculty, and that they were in my hometown. And that's how I reached out to them and said, hey can we have coffee? And Cliff said, yes. And so...   0:21:53.1 Andrew Stotz: And what was that, what year was that roughly?   0:22:00.3 Dave Williams: That would've been back in 2002 or 2003, somewhere in that vicinity.   0:22:02.0 Andrew Stotz: Hmm. Okay.   0:22:06.8 Dave Williams: Maybe a little bit later.   0:22:06.9 Andrew Stotz: I just for those people that are new to the topic and listening in I always give an example. When I worked at Pepsi... I graduated in 1989 from university with a degree in finance. And I went to work at Pepsi in manufacturing and warehouse in Los Angeles at the Torrance Factory originally, and then in Buena Park. But I remember that my boss told me, he saw that I could work computers at that time, and so I was making charts and graphs just for fun to look at stuff. And he said, yeah, you should go to a one of these Deming seminars. And so he sent me to the one in... At George Washington University back in 1990, I think it was. And but what was happening is we had about a hundred trucks we wanted to get out through a particular gate that we had every single morning. And the longer it took to get those trucks out the longer they're gonna be on LA traffic and on LA roads, so if we can get 'em out at 5:00 AM, fantastic. If we get 'em out at 7:00, we're in trouble. And so they asked me to look at this and I did a lot of studying of it and I was coming for like 4:00 in the morning I'd go up to the roof of the building and I'd look down and watch what was happening. And then finally I'd interview everybody. And then finally the truck drivers just said, look, the loaders mess it up so I gotta open my truck every morning and count everything on it. And I thought, oh, okay.   0:23:23.7 Andrew Stotz: So I'll go to the loaders. And I go, why are you guys messing this up? And then the loaders was like, I didn't mess it up. We didn't have the production run because the production people changed the schedule, and so we didn't have what the guy needed. And so, and oh, yeah, there was a mistake because the production people put the product in the wrong spot, and therefore, I got confused and I put the wrong stuff on by accident. And then I went to the production people and they said, well, no, it's not us. It's the salespeople. They keep putting all this pressure on us to put this through right now, and it's messing up our whole system. And that was the first time in my life where I realized, okay, it's a system. There's interconnected parts here that are interacting, and I had to go back into the system to fix, but the end result was I was able to get a hundred trucks through this gate in about 45 minutes instead of two hours, what we had done before.   0:24:18.8 Andrew Stotz: But it required a huge amount of work of going back and looking at the whole system. So the idea of looking at the science of improvement, as you mentioned, and the System of Profound Knowledge, it's... There's a whole process. Now, I wanna ask the question for the person who gets this book and they dig into it, it's not a small book. I've written some books, but all of 'em are small because I'm just, maybe I just can't get to this point. But this book is a big book, and it's got about 300... More than 300 pages. What's the promise? What are they gonna get from digging into this book? What are they gonna take away? What are they gonna be able to bring to their life and their business that they couldn't have done without really going deeper into this material?   0:24:57.7 Cliff Norman: Dave, go ahead.   0:25:01.4 Dave Williams: Well, I was gonna joke by saying they're gonna get hard work and only half because this is just the theory in the book and many of the... And sort of examples of the method. But we're in the process of preparing a field guide which is a much deeper companion guide loaded with exercises and examples of and more of the methods. So the original guide that that API had developed was actually about an eight... Well, I don't know how many pages it was, but it was a thick three inch binder. This, what you have there is us refining the content part that explains the theory and kind of gets you going. And then we moved all of the exercises and things to the field guide for people that really wanna get serious about it.   0:26:00.3 Dave Williams: And the reason I say hard work is that the one thing that you won't get, and you should probably pass it if this book if you're on Amazon, is you're not gonna get an easy answer. This is, as a matter of fact, one of the things that emerged in our early conversations about was this project worth it? Is to say that this is hard work. It's work that a very few number of leaders who or leadership teams that really want to learn and work hard and get results are gonna embark on. But for those, and many of our clients, I think are representative of that, of those people that say, gosh, I've been working really hard, and I feel like we could do better. I feel like I could make a bigger impact, or I could serve more customers or clients.   0:26:44.0 Dave Williams: And but I am... And I'm in intrigued or inspired or gotten to a certain point with improvement science on my own, but I want to figure out how to be more systematic and more global and holistic at that approach. Then that's what QOS is about. It builds on the shoulders of the other books that you mentioned, like The Improvement Guide which we talked about as being a great book about improvement, and improvement specifically in the context of a project. And other books like The Healthcare Data Guide and the Planned Experimentation, which are also about methods, healthcare Data Guide being about Shewhart charts, and Planned Experimentation being about factorial design. This book is about taking what Cliff described earlier as that... I always say it's that that diagram that people put on a slide and never talk about from Deming of production views as a system and saying, well, how would we do this if this is the model for adopting quality as strategy, what are the methods that help us to do this?   0:28:01.3 Dave Williams: And this book breaks that down into five activities that are built on the shoulders of profound knowledge, built on the shoulders of the science of improvement and provide a structure to be able to initially develop a system, a systems view of your organization, and then build on that by using that system to continually operate and improve that organization over time. So the book describes the activities. The book describes some of the things that go into getting started, including being becoming good at doing results-driven improvement, building a learning system, focusing in on the things that matter to your organization. And then working towards building the structure that you can improve upon. The book creates that foundation. It provides examples from clients and from people that we've worked with so that you can see what the theory looks like in practice get, kind of get a flavor for that. And we hope it builds on the shoulders of other work that I mentioned in the other books that compliment it and provides a starting point for teams that are interested in taking that journey.   0:29:26.5 Andrew Stotz: And Cliff, from your perspective, if somebody had no, I mean, I think, I think the Deming community's gonna really dive in and they're gonna know a lot of this stuff, but is gonna help them take it to the next level. But for someone who never had any real experience with Deming or anything like that, and they stumble upon this interview, this discussion, they hear about this book, can they get started right away with what's in this book? Or do they have to go back to foundations?   0:29:49.6 Cliff Norman: No, I think that can definitely get started. There's a lot of learning as you know, Andrew, from going through the four-day to understand things. And I think we've done a pretty good job of integrating what Dr. Deming taught us, as well as going with the methods. And one of the things people would tell him in his four-day seminars is, Dr. Deming, you've given us the theory, but we have no method here. And he said, well, if I have to give you the method, then you'll have to send me your check too. So he expected us to be smart enough to develop the methods. And the API folks did a really good job of translating that into what we call the five activities. So those five activities are to understand the purpose of the organization.   0:30:35.6 Cliff Norman: And a lot of people when they write a purpose, they'll put something up there but it's usually we love all our people. We love our customers even more. If only they didn't spend so much, and we'll come out with something like that and there'll be some pablum that they'll throw up on the wall. Well, this actually has some structure to it to get to Deming's ideas. And the first thing is let's try to understand what business we're in and what need we're serving in society that drives customers to us. So that word is used not need coming from customers, but what is it that drives them to us so we can understand that? And then the second part of that purpose needs to define the mainstay, the core processes, the delivery systems that relate directly to customers. And just those two ideas alone, just in the first activity of purpose, most people haven't thought about those ideas.   0:31:27.8 Cliff Norman: And can somebody pick up this book and do that? Yes. And that will answer a big challenge from Dr. Deming. Most people don't even know what business they're in, haven't even thought about it. And so that we... That question gets answered here, I think, very thoroughly. In this second activity, which is viewing the organization as a system contains two components that's viewing the organization as a system. And that's difficult to do, and a lot of people really don't see the need for it. Jane Norman reminded Dave and I on a call we did last week, that when you talk about a systems map with people, just ask 'em how do they know what's going on inside other organizations, other departments within their organization? How do they know that? And most of us are so siloed.   0:32:11.2 Cliff Norman: Somebody over here is doing the best job they can in department X, and meanwhile, department Y doesn't know anything about it. And then three months later the improvement shows up and all of a sudden there's problems now in department Y. Well, somebody who's focused on the organization as a system and sees how those processes are related when somebody comes to a management meeting said, well, we've just made a change here, and this is gonna show up over here in about three months, and you need to be prepared for that. Andrew, that conversation never takes place. So the idea of having the systems map and this book can help you get started on that. The second book that Dave was just talking about, there are more replete examples in there. I mean, we've got six case studies from clients in there than the practitioners and people who actually are gonna be doing this work.   0:33:01.7 Cliff Norman: That's gonna be absolutely... They're gonna need that field guide. And I think that's where Dave was coming from. The third activity is the information activity, how are we learning from outside the organization and how do we get feedback and research into the development of new products and services and the rest of it? And so we provided a system there. In fact, Dave took a lead on that chapter, and we've got several inputs there that have to be defined. And people just thinking through that and understanding that is huge. When Dr. Deming went to Japan in 1950, he was there to do the census to see how many Japanese were left after World War II. And then he got an invitation to come and talk to the top 50 industrialists. And he started asking questions and people from the Bank of Tokyo over there and all the rest of it.   0:33:52.4 Cliff Norman: And Dr. Deming says, well, do you have any problems? And they said, what do you mean? He says, well, do customers call up and complain? And he said, yes. And he says, well, do you have any data? And he said, no. He says, but if they complain, we give them a Geisha calendar. And then Dr. Deming says, well, how many Geisha calendars have you given out? So it's like, in 1991, I'm sitting here talking to a food company and I asked him, I said, well, you get customer complaints? Oh yeah. Do you have any data on it? No, but we give 'em a cookbook. I said, well, how many cookbooks are you giving out? So I was right back to where Deming was in 1950, so having the information activity, that third activity critical so that we're being proactive with it and not just reactive.   0:34:43.7 Cliff Norman: And so I think people can read through that and say, well, what are we doing right now? Well, I guess we're not doing this and move on. Then the fourth activity is absolutely critical. This is where you know that you've arrived, because now you're going to integrate not only the plan to operate, but a plan to improve. That becomes the business plan. For most people in business plan they do a strategy, and then they have a bunch of sub strategies, and they vote on what's important, and they do some other things, and then a year later they come back and revisit it. Well, what happens here is there's some strategic objectives that are laid out, and then immediately it comes down to, okay, what's gonna be designed and redesigned in this system? Which processes, products and services are gonna be designed? 'Cause we can all see it now, Andrew.   0:35:31.6 Andrew Stotz: Mm.   0:35:31.6 Cliff Norman: We can, it's right in front of us. So it's really easy to see at this point, and now we can start to prioritize and make that happen on purpose. As an example when Jane was a vice president at Conagra, they came up with five strategic objectives. Then they made a bunch of promises to corporate about what they were gonna do and when they were going to achieve it. When she laid out the systems map for them, they were horrified that over 30% of the processes that they needed to be having precooked meat didn't even exist. They were gonna have to be designed. And so Jane and I sat there and looking at 'em and said, well, if you'd had this map before you made the promises, would you have made those promises? No, no, we're in trouble right now. I gotta go back to the CEO of the holding company and tell 'em we're not gonna make it.   0:36:22.4 Cliff Norman: But there's a whole bunch of people that sit around in goal settings. We're gonna do this by when and have no idea about what they're talking about. So that's a little bit dangerous here. And then the fifth activity, it's probably the most important. And where I want people to start, I actually want 'em to start on the fifth activity, which is managing individual improvement activities, team activities. And what I mean by that is, nothing can hold you up from starting today on making an improvement and use the model for improvement. The three basic questions, you can write that on an envelope and apply it to a project and start right away. Because learning the habit of improvement, and when you identify, and this is typical in the planning process, again, a chapter that Dave took a lead on in the planning chapter.   0:37:03.8 Cliff Norman: When you lay that out, you're gonna come up with three to five strategic objectives, but that's gonna produce anywhere between 15 and 20 improvement efforts. And when people start three improvement efforts, and they see how difficult that is to traffic through an organization, particularly if you have a systems map, makes it a lot easier. If you don't have that, then there's all sorts of things that happen to you.   0:37:21.3 Andrew Stotz: Hmm.   0:37:22.8 Cliff Norman: But the, the idea of that all coming together is critical. And where you... Where that really shows up for the reader here is in chapter one. So Lloyd Provost took a lead on chapter one. If you read chapter one, you got a pretty good idea of what's gonna happen in the rest of the book. But more importantly, in that book, in chapter one, there's a survey at the end. And every time we give this out to people, they feel real bad.   0:37:48.1 Cliff Norman: And well, Cliff, any, on a scale of one to 10, we only came up with a four. Well, what I would tell 'em is, if you can come up with a four, you're pretty good. And those fundamentals have to be in place. In other words, the management needs to trust each other. There are certain things that have to be in place before you can even think about skating backwards here. And quality as an organizational strategy is all about skating backwards. The people who don't have the fundamentals can't even start to think about that.   0:38:15.0 Cliff Norman: So that survey and the gap between where they are at a four and where they're going to be at a 10, we've integrated throughout the whole book. So as you're reading through the whole book, you're seeing that gap, and then you have a good plan forward as to what do I need to do to get to be a six, an eight, and what do I need to do to finally arrive at a 10? Dave, why don't you add to what I just said there, and I gotta turn on a light here, I think.   0:38:39.2 Dave Williams: Well, I think one of the things that, and Cliff has probably been the one that has helped me appreciate this to the biggest degree is the role in which improvement plays in quality as an organizational strategy. So, I mean, I think in general, in our world, improvement is seen as kind of like a given, but in our case, what we've found is that many times people are not working on the things right in front of them or the problems in which they have, that they are on the hook... I like to say, are on the hook to get accomplished right now. And like Cliff mentioned, many of my clients when I engage with them, I say, well, what have you promised this year? And they'll give me a list and I'll say, well, okay, what are you working on to improve? And they'll be working on projects that are not related to that list of things that they've got to affect. And so usually that's a first pivot is to say, well, let's think about what are the things that you're working on or should be working on that are either designing or redesigning your system to achieve these strategic objectives.   0:39:48.8 Dave Williams: And the reason to put the attention on that fifth activity and get people working on improvement, there's a good chance that the improvement capability within the organization currently isn't to the level that you need it, where you can get results-driven projects happening at a clip that will enable you to chip away at 20 projects versus four in a year. And that it's not well integrated into the leadership, into the support structures that you have. In addition, if you're trying to use improvement on things that you're on the hook for, and Cliff noted, especially if you've got a system map while you're on that journey, you're gonna start to pick up on where the disconnects are. Similar to your example, Andrew, where you were describing your experience working backwards in the process, you're going to start to recognize, oh, I'm working on this, but it's linked to these other things. Or in order for me to do this, I need that. Or... And so that amplifies the project to be kind of just a vehicle to appreciate other things that are interconnected, that are important in improving our work together.   0:41:05.1 Dave Williams: And so I think that that's a critical piece. I mean, I sometimes describe it as the disappointment that people have when they open QOS because they want to have a new method or a new thing to work on. I said, well, there's a lot new in here. And at the same time, we want to build on the shoulders of the fundamentals. We want to build it because it's the fundamentals that are going to be able for you to activate the things that are necessary in order for you to skate backwards, like Cliff was describing earlier.   0:41:36.2 Cliff Norman: I got to add to what Dave was saying because this actually happened to me with a... I'm not going to mention the name of the company, but it's a high-tech companies worldwide. And we got up, a good friend of mine, Bruce Bowles, and we were introducing the idea of quality as an organizational strategy. And one of the guys in the front row, he says, Cliff, this just sounds like common sense, why aren't we all doing this? I said, that's a real good question. Let me put that in the parking lot here. So I put it up on a flip chart. And so we went through the idea of... We were working on Shewhart control charts. And so we showed him one of those. And at the end of all that, he raised his hand and I said, yeah, he says, Cliff, this is hard. I said, well, let me put that up here. This is hard. Then we went through the systems map and he says, look, this is hard. By the end of the two days, it was, this is hard, this is hard, this is hard, this is hard. This goes back to what Dave was saying earlier about once you open this page, there's some work that takes off, but more importantly, there's something new to learn here.   0:42:40.3 Cliff Norman: And that's frustrating to people, especially when they've got to quit doing what they've done in the past. It's what Deming says, you got to give up on the guilt and you got to move forward and transform your own thinking. So there's something here for the management to do. And if they're not willing to do that work, then this is probably not a good thing for them. Just go back to the blame flame and circling org charts and that kind of stuff and then wonder why we're losing money.   0:43:11.8 Andrew Stotz: Yeah, and I think that that's one of the things that we see in the Deming community is that, why are people doing it the way they are, dividing things up and doing KPIs and saying, you take care of that. And we're gonna optimize by focusing on each... We see how that all kind of falls apart.   0:43:27.9 Cliff Norman: It all falls through reductionism.   0:43:29.8 Andrew Stotz: [laughter] Yeah.   0:43:32.5 Cliff Norman: It doesn't understand the system, yeah.   0:43:32.5 Andrew Stotz: Yeah, so what I want to do now is I was just thinking about a book on my shelf called "Competitive Strategy" by Michael Porter. And there's a whole field of study in the area of strategy for businesses. Now you guys use, and you explain a little bit about the way you come up with... Why you come up with organization rather than let's say company as an example. But let's just talk about strategy for a moment. Generally we're taught in business school that there's two main strategies. One is a differentiation strategy. I like to teach my students like Starbucks. It's very differentiated from the old model. And you can have a low cost strategy, which is like McDonald's, where it's all about operational efficiency.   0:44:18.4 Andrew Stotz: And those are two different strategies that can get to the same goal, which is to build a strong and sustainable business that's making a good profit for the employees to get paid well and for shareholders. And so for somebody that understands some of the foundations of typical strategy, it's hard for them to think, wait, wait, wait, what? You're just talking about just better quality is the strategy? How should they frame this concept of quality as a strategy in relation to what we've been taught about low cost and differentiation and other types of strategy? How do we think about this book in relation to that?   0:45:03.2 Cliff Norman: When Deming wrote his book, his very first one of the four "Out of the Crisis", which was the whole idea about quality and competitive position. But he was kind of answering that. And at that time, what we had is we had three companies in the United States that were going at each other, Ford, GM, and Chrysler. And they'd call each other up, well, what are you doing this year? Oh, we're making cars that don't work. Sometimes they break down. That's why we have Mr. Goodwrench to repair them. That's an extra revenue source for us. As one of the executives that are challenged, a colleague of mine, he said, you don't realize how much money we're gonna lose here taking the repair business out because we make a lot of money out of repair. So making cars that don't work has been a good revenue stream for us. Well, all that works out great, until somebody shows up like Toyota that has a car that works and doesn't need to be repaired by Mr. Goodwrench all the time.   0:45:58.8 Cliff Norman: So the mind shift there, and what Dr. Deming was saying is that he was focused on the competition's already licked. And I don't think Porter's thought about that very much, not to be overly critical, because I'm an admirer of his, but the idea of focusing on the need and why is that customer coming to us so that we make a journey, and the Japanese call that being in the Gemba, being in the presence with the customers as they use the product or service and doing the research and the rest of it. And then coming back and then redesign that product or service so that it not only grabs the current customer, but we start thinking about customers that are not even our customers and innovate and actually come up with a design that actually brings new customers to us through products and services that we haven't thought about yet. So if I show you three products just to make a picture of it, we often show like an abacus, which was a hand calculating machine about BC. Then there's a slide rule that came out about the same year that Columbus discovered America. And that was good till about 1968.   0:47:06.0 Cliff Norman: And then the calculator, the handheld calculator came out. Well the need for all three of those products is to do handheld calculations. So we've had that need since BC. Now in 1967, K&E Calculator was making that slide rule, which I used in junior high school. If you'd have come up to me and said, Cliff, what do you need in the way of a better slide rule? I said, well can you get me a holster for it? 'Cause I don't like having to stick me in the face. I put it in my pocket and it sticks me in the face. And if you can give me a holster for that, that would be my view of that. I wasn't about to come up with the TI calculator. That wasn't gonna happen. Not from Cliff. It's gonna come from an engineer at TI. Now, K&E Calculator, if they'd been doing research in the marketplace and saying, is there something that can totally disrupt us going on here? Rather than just looking at figuring out a way to make the K&E slide rule better, they might've discovered that.   0:48:07.0 Cliff Norman: Most people don't do that. They just go back. They just lose their business. And it was interesting in '67, their annual report put out, what's the world gonna look like 100 years from now? So they had dome cities, they had cars flying, they had all sorts of things going on that were great innovations, but they didn't have the TI calculator in there, along with the HP calculator. And that wiped out their business. And so if people understand the need, and that's what Dr. Deming is getting at, he says, they really haven't thought about what business they're in. So why are the customers coming to us? He says, no customer ever asked for pneumatic tire. No customer ever asked for a microwave oven. That came from people with knowledge that were looking at how the customers are using the current products and services and say, now, is there technology innovation going on that we can actually do a better job of providing a better match in the future?   0:48:56.9 Andrew Stotz: And can you explain why you use the word need as opposed to want?   0:49:06.5 Cliff Norman: That's a good question. The idea is that there's a need that's constant in society. So that need of having to do handheld calculations or needing healthcare or to pay bills, that need is constant throughout civilization. And so if I want something that's interesting, that might be the match. That might be something to do with some features what I'm offering and so forth. I'd like to have this, I'd like to have that. But the need and the way we're using that is it doesn't come from customers. It's what drives customers to us. And it's always been there. It's always been there. Need for transportation, for example. Whether you're walking or driving a bicycle or a car or a plane.   0:49:53.6 Andrew Stotz: And Dave, how would you answer the same question when you think about a person running a business and they've had many strategy meetings in their business, they've set their corporate strategy of what we're doing, where we're going and that type of thing. And maybe they've picked, we're gonna be a low cost producer. Thailand's an interesting one because Thailand had a ability to be low cost producers in the past. And then China came along and became the ultimate low cost producer. And all of a sudden, Thai companies had a harder time getting the economies of scale and the like. And now the Chinese manufacturers are just really coming into Thailand, into the Thai market. And now it's like, for a Thai company to become a low cost leader is almost impossible given the scale that China and the skills that they have in that. And so therefore, they're looking at things like I've got to figure out how to get a better brand. I've got to figure out how to differentiate and that type of thing. How does this... How could this help a place like that and a management team that is struggling and stuck and is looking for answers?   0:51:07.0 Dave Williams: Well, I go back to what Cliff said about that many organizations don't pause to ask, why do they exist? What is the need of which they are trying to fulfill? Much of my background involved working in the service industry, initially with public safety and ambulance systems and fire systems, and then later in healthcare and in education. And in many of those environments, especially in places where in public systems where they've been built and they may have existed for a long time, when you ask them about what are they trying to accomplish as an organization or what is it that they... The need that they're trying to fulfill? Typically, they're gonna come back to you with requests or desires or wants or sort of characteristics or outcomes that people say they expect, but they don't pause to ask, like, well, what is the actual thing of which I'm trying to tackle? And Cliff mentioned like, and we actually, I should mention in the book, we have a list of different strategies, different types of strategies, all the different ones that you mentioned, like price and raw material or distribution style or platform or technology.   0:52:30.9 Dave Williams: There's different types of strategies, and the one that we are focusing in on is quality. But I think it's important for people to ask the question. Cliff mentioned transportation. There's a number of different great examples, actually, I think in transportation, where you could look at that as being an ongoing need as Cliff mentioned from the days when there was no technology and we were all on foot to our current day. Transportation has been a need that existed and many different things over time have been created from bicycles, probably one of the most efficient technologies to transport somebody, wheels and carts. And now, and you were referencing, we've made reference to the car industry. It's a fascinating experience going on of the car world and gas versus electric, high technology versus not, autonomous vehicles. There's, and all of them are trying to ask the question of, are there different ways in which I might be able to leverage technology to achieve this need of getting from point A to point B and be more useful and potentially disrupt in the marketplace? And so I think the critical thing initially is to go back and ask and learn and appreciate what is that need?   0:53:58.6 Dave Williams: And then think about your own products and services in relation to that. And I think we include four questions in the book to be able to kind of think about the need. And one of those questions is also, what are other ways in which you could fulfill that need? What are other ways that somebody could get transportation or do learning or to help sort of break you away from just thinking about your own product as well? And that's useful because it's super tied to the system question, right? Of, well, this is the need that we're trying to fulfill and these are the products and services that are matching that need. Then the system that we have is about, we need to build that and design that in order to produce, not only produce the products and services that match that need, but also continually improve that system to either improve those products and services or add or subtract products and services to keep matching the need and keep being competitive or keep being relevant. And maybe if it's not in a competitive environment where you're gonna go out of business, at least be relevant in terms of the city service or community service, government service that continues to be there to match the need of the constituents. So I think it's a really important piece.   0:55:17.0 Dave Williams: It's that North star of saying, providing a direction for everything else. And going back to your original comment or question about strategy, and many times people jump to a strategy or strategies or, and those might be more around particular objectives or outcomes that they're trying to get to. It may not actually be about the method or the approach like cost or technology that they may not even think that way. They may be more thinking about a plan. And I really encourage people to be clear about what they're trying to accomplish and then start to ask, well, how's the system built for that? And later we can bring a process that'll help us learn about our system and learn about closing that gap.   0:56:05.1 Cliff Norman: Yeah. Just what I'd add to that, Andrew, because you mentioned China, a few other countries, but I think the days are coming to an end fairly quickly where somebody can say, oh, we can go to this country. They have low wages, we'll put our plant there and all that. There's a lot of pushback on that, particularly in the United States. And if that's your strategy, that hadn't required a lot of thinking to say the least. But in 1966, over 50% of the countries in the world were, let me rephrase that, over 50% of the population of the world lived in extreme poverty. So there were a lot of targets to pick out where you want to put your manufacturing. And in 2017, and you and Dave were probably like myself, I didn't see this hit the news, but that figure had been reduced from over 50% down to 9%. And all you have to do is just, and I worked in China a lot, they're becoming very affluent. And as they become very affluent, that means wages are going up and all the things that we want to see throughout the world. And I think that's happening on a grand scale right now, but you're also getting a lot of pushback from people when they see the middle class in their own country, like here in the United States, destroyed, and say, I think we've had enough of this. And I think you're gonna see that after January. You're gonna see that take off on steroids.   0:57:31.7 Cliff Norman: And that's gonna happen, and I think throughout the world, people are demanding more, there's gonna have to be more energy, every time a baby is born, the footprints gets bigger for more energy and all the rest of it. So it's gonna be interesting, and I think we are going into an age for the planet where people as Dr. Deming promised that they'd be able to live materially better, and the whole essence of this book is to focus on the quality of the organization and the design and redesign of a system to a better job of matching the need and cause that chain reaction to go off. When Jane and I went over to work in Sweden, Sven Oloff who ran three hospitals and 62 dental clinics there and also managed the cultural activities and young shipping. He said, Cliff, I report to 81 politicians. I don't wanna have to go to them to put a bond on an election to get more money for my healthcare system, I wanna use Dr. Deming's chain reaction here to improve care to the patients in my county and also reduce our costs. A whole bunch of people that don't even believe that's possible in healthcare.   0:58:39.9 Cliff Norman: But that's what Sven Oloff said that's what you're here for. And that's what we proceeded to do, they launched about 350 projects to do just that, and one of their doctors, Dr. Motz [?], he's amazing. We taught him a systems map, I came back two months later, and he had them in his hospital on display. And I said, Motz, how did you do this? He said well Cliff, I'm an endocrinologist by education as a doctor, of course, that's a person who understands internal systems in the body. So he said the systems approach was a natural for me. But I'd like to say it was that easy for everybody else, that systems map idea and as you know, being in the Deming seminar, that's quite a challenge to move from viewing the organization as an org chart, which has been around since Moses father-in-law told him, you need to break up the work here a little bit, and the tens of tens reporting to each other, and then of course, the Romans took that to a grander scale, and so a centurion soldier had 100 other soldiers reporting to him. So we've had org charts long and our federal government took that to a whole new level.   0:59:46.1 Cliff Norman: But the idea is switching off the org chart from biblical times to actually getting it up to Burt [?] about 1935 and understanding a system that's kind of a nose bleed in terms of how much we're traveling there to get us into the 21st century here.   1:00:04.0 Andrew Stotz: And I left Ohio, I grew up outside of Cleveland, and I left Ohio in about 1985, roughly. And it was still a working class, Cleveland had a huge number of jobs and there was factories and all that, and then I went to California, and then I moved to Thailand in 1992. So when I go back to Ohio now, many years later, decades later, it's like a hollowed out place, and I think about what you're saying is... And what's going on in the world right now is that I think there's a desire in America to bring back manufacturing to bring back production and all of that, and that's a very, very hard challenge, particularly if it's gone for a while and the skill sets aren't there, maybe the education system isn't there, I talk a lot with John Dues here on the show about the what's happening in education and it's terrifying.   1:01:05.9 Andrew Stotz: So how could this be... Book be a guide for helping people that are saying, we've got to revitalize American production and manufacturing and some of these foundational businesses and not just services, which are great. How can this book be a guide?   1:01:25.8 Dave Williams: One thing I would say that I think is interesting about our times, many times when I reflect on some of the examples that you just provided, I think about how changes were made in systems without thinking about the whole system together. And there may have been changes at various times that we're pursuing particular strategies or particular approaches, so it may have been the low-cost strategy, it may have been to disrupt a marketplace. And oftentimes, they don't think about... When somebody's pursuing one particular view, they may miss other views that are important to have an holistic perspective. One of the things that I appreciate about QoS in the methods and overall as a holistic view of looking at organizations that it's asking us to really think initially about that North Star, what we're trying to do, our purpose, and what are the tenants. What are the things that are important us, the values...   1:02:38.7 Dave Williams: That are important to us in pursuing that particular purpose? And in doing that, really thinking about how does the system work as it is today, and if we make changes, how does it move in alignment with the values that we have and in the direction that we wanna go? And appreciating, I would say, part of the value of the scientific thinking that is in the Science of Improvement is that it encourages you to try to see what happens and appreciate not only what happens in relation to the direction you're trying to go, but also the... Have a balanced view of looking at the collateral effects of things that you do, and I think that systems do is really important there. So I think from that perspective, the quality as an organizational strategy brings a holistic picture into these organizations, or at least...   1:03:45.1 Dave Williams: To be paying attention to the system that you have, maybe the direction you wanna go, and what happens as you... What are your predictions and what do you see when you study the results of making changes in the direction of the vision that you have. And I think that's at a high level that is one of the ways that I think about it. Cliff, how would you add on there?   1:04:09.1 Cliff Norman: Your question made me think of something that happened about two years ago, Jane and I got a call from a lady that worked for her in one of the chicken plants, and she said, Jane, I had to call you because I need to order some of those Shewhart charts. But what happened today, you should have been here and Jane said, what... She said, Remember that 10 year thing we buried in the ground that we're gonna open up in 10 years, and she said, yeah, said, well, we opened it up today, and the new plant manager was here, and those Shewhart charts came out, and he looked at the costs on them. He said, you were operating at this level? She said, yeah, routinely. And he said what happened? He said, well, they had new management come in and they got rid of the charts, that's the first thing they did, and then gradually they try to manage things like they normally did, and then they forgot everything that we had learned. And that's kind of where we are right now.   1:05:11.0 Cliff Norman: So just think of that a decade goes by, and it just as Dr. Deming said, there's nothing worse than the mobility of management, it's like getting AIDS in the system. And they basically destroyed their ability to run a low-cost operation in an industry that runs on 1 or 2%. And when you watch that happen and understand that we still have food companies in this country, and we have to start there and start looking at the system anew and start thinking about how it can actually cause that chain reaction to take off, and that comes from focusing on quality of the system. And then as Dr. Deming says, anybody that's ever worked for a living knows why costs go down with two words less rework, but instead of people will put in extra departments to handle the rework. Next thing they start building departments to handle...   1:06:01.8 Cliff Norman: The stuff that's not working because the system they don't understand. So that was a... What do they call those things, Dave, where they put them in the ground and pull him out?   1:06:11.0 Dave Williams: Time capsule.   1:06:13.4 Andrew Stotz: Time capsule yeah.   1:06:13.5 Cliff Norman: Yeah. Time capsule. The a 10-year time capsule.   1:06:19.2 Andrew Stotz: It's a great, great story. And a great idea. We had a company in Thailand a very large company that the CEO of it came upon the idea of the teachings of Dr. Deming and over time, as he implemented it in his company, the Japanese Union of Scientists have their prize and his company won that prize and then he had about 10 subsidiary companies that also were doing it and they also won over time. And so Thailand is actually is the second largest recipient of the Japanese Deming Award outside of India. But he left and he retired and another guy took over, a very bright guy and all that, but he threw most of that out and focused on newer methods like KPIs and things like that. And just at the end of last year, maybe six months ago, they reported a pretty significant loss, and I was kind of made me think how we can spend all this time getting the Deming teachings into our business, and then one little change in management and it's done.   1:07:26.9 Andrew Stotz: And that made me think, oh, well, that's the value of the book, in the sense that it's about building the concept of quality as a core part of strategy as opposed to just a tool or a way of thinking that could go out of the company as soon as someone else comes in. Go ahead, Dave.   1:07:41.9 Dave Williams: I was gonna say, Andrew, you raise a point, I think it's really, really important and Cliff mentioned this in terms of the problem of mobility of management. One thing that I don't know that we outline probably in dark enough ink in the book is the critically important piece of leadership, building the structures and the capability. I know we talk a little bit about it, but doing it in a way that both builds up the people that you have... So Cliff emphasiz

On episode 119 of PSQH: The Podcast, IHI VP Patricia McGaffigan and Dr. Marguerite Cunningham, Vice President and Chief Nursing Informatics Officer at Inova Health, talk about the IHI's nurse-led pilot rapid cycle improvement program. This interview was recorded at the IHI Forum in Orlando.

David M. Williams, PhD is an internationally respected scholar-practitioner of the Science of Improvement. With 25 years of experience in improvement, he has worked with leaders and teams worldwide to develop people's abilities to make rigorous, results-driven improvements and adopt quality as an organizational strategy. Dr. Williams coauthored Quality as an Organizational Strategy: Building a System of Improvement. His writing on improvement is also found in many books and published papers. Dr. Williams is a former chief quality officer, consultant, and senior leader at the Institute for Healthcare Improvement. He is a lead faculty in IHI's Improvement Advisor Professional Development Program and developed and led IHI's Chief Quality Officer program. He created the Mr. Potato Head and Coin Spin PDSA exercises, which are used worldwide to teach PDSA testing and measurement for improvement.Dr. Williams is a former city paramedic and a subject matter expert on ambulance service system design.Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3CME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.

空の移動をもっと身近にしたいと思ってしまった4人のパパたち&1人のリケジョが、夜な夜なこっそり繰り広げる、eVTOL(=空飛ぶクルマ)に対する興味、好奇心、社会実装への情熱を語り合うラジオです。 今回は川崎重工の創業期のエピソードです。 川重の祖業は実は東京？築地に開いた造船所が起源！作ったのは川崎正蔵！薩摩生まれの苦労人！餅も買えない貧乏さ！ 15歳から海運業に修行！でも抜け荷で幕府のコンプラアウト？そんな中での長崎への転勤！そして受ける衝撃！ 異国の文明に触発され、昼は仕事で夜は勉強！移動中にも本と辞書でしっかり勉強！努力を惜しまない正蔵！ 時代は開国、激動期！幕府も建造の禁を解く！石川島造船所や長崎造船所もこの頃に設立！IHIや三菱重工の起源がここに！ 正蔵27歳、独立！満を持して大阪で海運業で一旗あげる！と思いきや船が沈んで倒産？まさかの急死に一生で固まる決意？日本の船を近代化せよ！ 海運会社に拾われる正蔵！実力発揮で前島密からも認められ出世！一方、日本近海運の欧米資本の独占に明治政府の募る危機感！ サラリーマン正蔵42歳、再び起業！時の元勲、松方正義の支援も受け、「川崎築地造船所」開設！ド派手にやるぜ進水式！かかった費用は船価以上？ 時勢に乗り造船所拡張へ！官有地の払い下げも決定！正蔵、50歳についに神戸の地へ！ 後継者に悩む正蔵、白羽の矢を立てたのは松方家の三男、幸次郎？…などなど。 造船に人生を賭けた川崎正蔵のストーリーを解説します！ メッセージはこちらから https://forms.gle/mib37UcseFvpzyGa8 関連リンク ■日本の空のパイオニアたち 明治・大正18年間の航空開拓史 荒山 彰久(著) https://www.waseda-up.co.jp/history/post-623.html ■ 火輪の海 松方幸次郎とその時代 復刻版【新装】 / 神戸新聞社・編 https://amzn.asia/d/1nVQWBb ■川崎重工業株式会社 HP: https://www.khi.co.jp/corporate/timeline/ SNSリンク ■X/Twitter https://twitter.com/evtolradio

　株式会社スマサポは9月13日、IHI運搬機械株式会社と共同で提供していた賃貸不動産内覧サービスでの情報漏えいの可能性について発表した。

　IHI運搬機械株式会社は9月13日、株式会社スマサポと共同で提供していた賃貸不動産内覧サービスでの情報漏えいの可能性について発表した。

空の移動をもっと身近にしたいと思ってしまった4人のパパたち&1人のリケジョが、夜な夜なこっそり繰り広げる、eVTOL(=空飛ぶクルマ)に対する興味、好奇心、社会実装への情熱を語り合うラジオです。引き続き日本の航空黎明期編、現在にも航空機事業で活躍する重工業各社の航空機事業への取り組みにフォーカスします！立ち上げフェーズから量産フェーズへ？0→1から1→100を担ったメーカー4社にフォーカス！航空機から祖業しているSUBARUと新明和工業！造船祖業の川崎重工と三菱重工！でも、下手するとただひたすら社史朗読？SUBARU！今は華麗な自動車メーカーも、祖業は東洋最大の飛行機工場を有した中島飛行機の創業者「中島知久平」！起業家の顔だけでなく、軍人、国会議員、大臣、A級戦犯まで...豪快な人生にフォーカス！新明和工業！飛行艇で有名なあの会社！中島知久平との決別し、川西機械製作所を創業した川西清兵衛とその後継者、川西龍三についてフォーカス！川崎重工業！バイクで有名な通称川重なあの会社！川崎造船所としてスタートするも、最初の祖業は築地？初代社長の松方幸次郎らにフォーカス！三菱重工業！ザ・重工！重工さんといえばこの会社。近年株価爆上げ？三菱グループの初代社長 岩崎 彌太郎と、三菱内燃機製造として、航空機へ進出した岩崎小彌太にフォーカス！他にも、「重工業」の邦語は小弥太作成？機体5社って何？IHIは？大戦中の航空機マニアが怖い...などなど。現在も続く4社の歴史や人物を深堀していきます！メッセージはこちらから https://forms.gle/mib37UcseFvpzyGa8関連リンク■株式会社SUBARU HP: https://www.subaru.jp/brand/technology/history/■新明和工業株式会社 HP: https://www.shinmaywa.co.jp/company/history/■川崎重工業株式会社 HP: https://www.khi.co.jp/corporate/history/■三菱重工業株式会社 HP: https://www.mhi.com/jp/company/overview/history.htmlSNSリンク ■X/Twitter https://twitter.com/evtolradio

In this Vital Health Podcast, recorded live at the 2024 Bio International Conference, host Duane Schulthess sits down with Niklas Blomberg, the Executive Director of the EU Innovative Health Initiative (IHI). Together, they delve into the transformative journey from the Innovative Medicines Initiative to the broader, more inclusive Innovative Health Initiative. Niklas shares his perspectives on fostering collaboration between pharmaceuticals, medical technologies, and diagnostics while elaborating on the challenges and strategies for integrating diverse sectors in healthcare research. Discover how IHI is breaking down silos and creating a collaborative platform that brings together regulators, industry players, and patient organizations. Nicholas also touches on the importance of comprehensive public healthcare systems, the role of SMEs in innovation, and the exciting projects on the horizon, including those addressing regulatory science and digital health. Whether you are interested in public-private partnerships, healthcare innovation, or the future of medical research in Europe, this episode will provide valuable insights and forward-thinking ideas. It's an engaging discussion with one of the leading voices in global health research.See omnystudio.com/listener for privacy information.

Join us, Thomas Reichart and Justin Tomlinson, as we sit down with Dr. Christian Muehlendyck, the lead for the Scientific Partnerships of J&J MedTech in EMEA, and special guest host Dr. Wolfgang Golisch to discuss the future of healthcare through the lens of data-driven innovation.  Dr. Christian Mühlendyck is the Scientific Partnerships Lead for J&J MedTech EMEA.  Within this role he is also the industry coordinator of the IHI funded IDERHA consortium. IDERHA aims to addresses the obstacles in accessing and analyzing health data to maximize their value for patient care and medical research by building one of the first pan-European health data spaces. To enable patients and healthcare providers to benefit from innovative health solutions, it also seeks to accelerate policy developments of real-world evidence acceptance for regulatory approval and Health Technology Assessments (HTA). His expertise in health research and digital health combined with his clinical and long leadership experience fuel this significant initiative. For more details and to follow IDERHA: Web: http://www.iderha.org LinkedIn: https://www.linkedin.com/company/iderha/?lipi=urn%3Ali%3Apage%3Ad_flagship3_search_srp_all%3BgjBPph06TUCprghD9PG2HQ%3D%3DInnovative Health Innitiative : IHI

On the show today, I'm speaking with researcher and founder of the Atua Matua framework, Dr Ihirangi Heke. Ihi builds health, wellness and performance practices based on traditional environmental knowledge. In this conversation, Ihi and I discuss the good ol' days of PE school in Dunedin and the changes that have taken place since. Ihi shares some of his early experiences growing up in the great outdoors and what led to his work studying environmental science. We talk about genetic ways of knowing developed over multiple generations and how learning takes place from a Māori perspective. And we discuss how you can use an environmentally centred approach to development to take you past what you ever imagined was possible. Enjoy!Sign up for Craig's newsletter (Beyond the Game) at athletedevelopmentproject.com/newsletterGet Craig to speak at your club or school here. Connect with Craig:Instagram: instagram.com/drcraigharrison/Facebook: facebook.com/drcraigharrisonTwitter: twitter.com/drcraigharrisonSupport the Show.

Show SummaryOn today's episode, we feature Kate DeBartolo, a senior director for the Institute for Healthcare Improvement and the leader for the conversation project. IHI has public engagement initiative to help people share their wishes for care through the end of their lifeAbout Today's GuestKate DeBartolo is a Senior Director at the Institute for Healthcare Improvement (IHI) and leads The Conversation Project, IHI's public engagement initiative to help people share their wishes for care through the end of life. The Conversation Project was founded in 2010, on the belief that these discussions should begin at the kitchen table—not in the intensive care unit. The Conversation Project offers free tools, guidance, and resources to begin talking with those who matter most about your and their wishes.  Kate joined IHI in 2007, with earlier work designing and executing the national field operations for IHI's hospital-based programs. Prior to joining IHI, Kate worked as a grant analyst at The California Endowment. She is a graduate of Wellesley College and currently lives in Washington DC with her husband and son. Links Mentioned In This EpisodeThe Conversation Project WebsitePsychArmor Resource of the WeekThis week's PsychArmor resource of the week is the PsychArmor course Caring for Veterans through End of Life: Caregivers and Loved Ones. In this course, you will learn how to support and care for Veterans as they near the end of their lives. We will explore the impact of the final journey on caregivers and loved ones, and the importance of planning and respite care. We will discuss how a Veteran's service in different eras may impact their care and the unique challenges faced by caregivers and loved ones in the grieving process. By the end of this course, you will have the knowledge and skills necessary to provide compassionate care and support to Veterans and their families during this important time.  You can see find the course here:  https://learn.psycharmor.org/courses/caring-for-veterans-through-the-end-of-life-caregivers-and-loved-ones This Episode Sponsored By: This episode is sponsored by PsychArmor. PsychArmor is the premier education and learning ecosystems specializing in military culture content PsychArmor offers an. Online e-learning laboratory that is free to individual learners as well as custom training options for organizations. Contact Us and Join Us on Social Media Email PsychArmorPsychArmor on TwitterPsychArmor on FacebookPsychArmor on YouTubePsychArmor on LinkedInPsychArmor on InstagramTheme MusicOur theme music Don't Kill the Messenger was written and performed by Navy Veteran Jerry Maniscalco, in cooperation with Operation Encore, a non profit committed to supporting singer/songwriter and musicians across the military and Veteran communities.Producer and Host Duane France is a retired Army Noncommissioned Officer, combat veteran, and clinical mental health counselor for service members, veterans, and their families.  You can find more about the work that he is doing at www.veteranmentalhealth.com  

「国交省がIHI原動機の新潟・群馬の工場に立ち入り　船舶・陸上用エンジン4361台の「燃料消費率」測定データを改ざんか」　エンジンメーカーの「IHI原動機」が、船舶用のエンジンなどの出荷時にデータを改ざんしていた問題で、国土交通省は、新潟県と群馬県のIHI原動機の工場に立ち入り検査に入った。25日午前9時半ごろ、新潟市と群馬・太田市にあるIHI原動機の工場に、国土交通省の職員が立ち入り検査に入り、関係者への聞き取りを行い、事実確認を進めている。IHI原動機は、2003年以降に出荷した船舶用と陸上用のエンジン5537台のうち4361台について、顧客に提出する「燃料消費率」の測定データを改ざんしていた。1980年代後半から改ざんが行われていた可能性もあり、国交省は会社側に2003年以前の改ざんがなかったか確認するとともに、再発防止策を求めている。

「IHI子会社が船舶用と陸上用のエンジンの顧客提出用データを改ざん　1980年代後半から？4000台あまり改ざんか」　大手機械メーカーのIHIは、子会社が船舶用のエンジンなどの出荷時に、データを改ざんしていたと発表した。IHI・盛田英夫副社長「大変申し訳ございませんでした」IHI原動機は、船舶用と陸上用のエンジンを出荷する際に、顧客に提出する「燃料消費率」の測定データを改ざんしていたという。改ざんは、2003年以降に出荷した約5500台のうち4000台余りで行われ、「燃費データをよく見せる」修正もあったと説明している。これまでに安全性に関わる事象は確認されていないとしているが、1980年代後半から改ざんが行われていた可能性もあるということで、IHIは近く、特別調査委員会を立ち上げ、原因究明を進めるとしている。

Neste último episódio, o Dr. Lucas Zambon, Diretor Científico do IBSP faz uma restrospectiva da temporada, analisando os principais pontos de uma entrevista publicada pelo New England Journal of Medicine/NEJM Catalyst 2023, na qual algumas das maiores lideranças em Segurança do Paciente do mundo expuseram as suas opiniões sobre os dados atuais da Segurança do Paciente.Esta edição trouxe também o importante ponto de vista de Don Berwick, Presidente Emérito do IHI, quem refletiu sobre o tema em seu artigo "Constansy of Purpose for Improve Patient Safety - Missing in Action", publicado em janeiro de 2023 na New England Journal of Medicine.#IBSP #SegurançaDoPaciente #PodCast #IBSPPodcast #NovoEpisódio #NEJM #Qualidade #Dados #patientsafety

ON PODCAST 142DONATE: PAYPAL.ME/JAPANWUTThe rising use cases of AI for cultural and political soft power, a WEF Death Cult Economist gets his Japanese booze ad pulled, and Japan's push to adopt ammonia as a green resource. Strap in. You are living in Interesting Times.Follow: Twitter / Facebook Page / InstagramOfficial Website, please share: matthewpmbigelow.comShow NotesOMGWTFWant to spruce up your bike helmet? Switch over to Oshare-heruJAPAN BUSINESSEconomist who advocated mass suicide pulled from Kirin adTOWARDS EQUALITY: Mercari official deciphers unexplained pay gapSOCIETY 5.0Japan prof. probes strengths, weaknesses of rapidly evolving AI translation: interviewAI supercharges threat of disinformation in a big year for elections globallyNew AI tools can record your medical appointment or draft a message from your doctorSUPPLY CHAIN WAR4 firms plan first ammonia-fueled ammonia carrier shipJapan's JERA, IHI to test ammonia as fuel at coal power plant

Trong lúc tình hình tại Biển Đông vẫn chưa lắng dịu, thì một vùng biển khác, Vịnh Bắc Bộ, phải chăng đang có nguy cơ trở thành một điểm nóng thứ hai giữa Việt Nam và Trung Quốc? Ngày 01/03/2024, Trung Quốc đã chính thức công bố đường cơ sở mới nêu rõ yêu sách lãnh thổ của họ ở phía bắc Vịnh Bắc Bộ, khu vực chung với Việt Nam. Thông báo trên trang mạng của Bộ Ngoại Giao Trung Quốc nêu lên 7 điểm cơ bản mà khi được kết nối sẽ tạo thành đường cơ sở cho các yêu sách chủ quyền của Bắc Kinh ở Vịnh Bắc Bộ. Thông báo đó đã làm dấy lên nhiều lo ngại về ý đồ của Bắc Kinh đối với vùng biển mà hai nước đã phân định ranh giới sau rất nhiều đàm phán. Nhiều ngày sau khi đường cơ sở mới được phía Trung Quốc công bố, Việt Nam mới lên tiếng vào ngày 14/03, qua lời phát ngôn viên bộ Ngoại Giao Phạm Thu Hằng. Hà Nội đề nghị Trung Quốc “tôn trọng và tuân thủ hiệp định về phân định lãnh hải, vùng đặc quyền kinh tế và thềm lục địa giữa hai nước trong Vịnh Bắc Bộ ký năm 2000, cũng như Công ước Liên Hiệp Quốc về Luật biển (UNCLOS) 1982".Đường cơ sở là đường ranh giới phía trong của lãnh hải và là ranh giới phía ngoài của nội thủy, do nước ven biển quy định trên cơ sở Công ước Liên Hiệp Quốc về Luật Biển năm 1982 (UNCLOS).Theo Công ước này, các quốc gia ven biển được hưởng lãnh hải 12 hải lý, vùng đặc quyền kinh tế 200 hải lý và thềm lục địa kéo dài tới 350 hải lý. Tuy nhiên, Vịnh Bắc Bộ, một vịnh nửa kín, bao quanh là Trung Hoa lục địa, Việt Nam và đảo Hải Nam của Trung Quốc, có chiều rộng tối đa không quá 180 hải lý. Cho nên có sự chồng chéo hoàn toàn về vùng đặc quyền kinh tế và thềm lục địa của cả hai quốc gia trong vùng Vịnh, nếu chiếu theo Công ước UNCLOSVào năm 2000, Trung Quốc và Việt Nam đã đạt được thỏa thuận vạch ra ranh giới lãnh hải, vùng đặc quyền kinh tế và thềm lục địa ở Vịnh Bắc Bộ. Cả hai bên đều coi thỏa thuận này là "công bằng", đánh dấu ranh giới trên biển đầu tiên của Trung Quốc. Nhưng dù đã đạt thỏa thuận này, tranh chấp vẫn tiếp diễn do vẫn văn bản chưa phân định rõ ranh giới hướng ra biển. Trả lời RFI Việt ngữ, nhà nghiên cứu Hoàng Việt ở Sài Gòn nhận định đường cơ sở mới mà Trung Quốc vừa công bố là "chưa thuyết phục": " Về Vịnh Bắc Bộ thì Việt Nam và Trung Quốc đã trải qua rất nhiều cuộc đàm phán và cuối cùng đã ký Hiệp định Phân định Vịnh Bắc Bộ, gọi đầy đủ hơn là "Hiệp định Phân định lãnh hải, vùng đặc quyền kinh tế và thềm lục địa tại Vịnh Bắc Bộ". Hiệp định được ký kết năm 2000 và có hiệu lực từ năm 2004, nay đã tròn 20 năm. Trước đó thì đương nhiên là Trung Quốc chưa bao giờ công bố đường cơ sở trong khu vực Vịnh Bắc Bộ, vì đây là vùng vốn có tranh chấp giữa Việt Nam với Trung Quốc. Cho nên có thể nói đây là lần đầu tiên Trung Quốc công bố một đường cơ sở trong khu vực Vịnh Bắc Bộ.Trung Quốc sử dụng phương pháp "đường cơ sở thẳng" đối với cả đường cơ sở trong Vịnh Bắc Bộ. Điều này có lẽ là chưa thuyết phục được nhiều người. Thứ nhất, Công ước về Luật Biển có quy định rằng ở những nơi mà vùng biển khúc khuỷu, lồi lỏm thì có thể áp dụng phương pháp "đường cơ sở thẳng". Trong trường hợp này thì khu vực của Trung Quốc ở Vịnh Bắc Bắc Bộ không phải là một khu vực khúc khuỷu lồi lỏm. Cho nên việc Trung Quốc áp dụng "đường cơ sở thẳng" là chưa hẳn thuyết phục. Điểm thứ hai là một số điểm cơ sở của Trung Quốc trong đường cơ sở thẳng này quá xa bờ và điều này làm dấy lên lo ngại là Trung Quốc không tuân thủ đúng Công ước về Luật Biển khi công bố đường cơ sở ở Vịnh Bắc Bộ."Bắc Kinh đã từng nói là những tranh chấp đó sẽ được giải quyết thông qua một quy trình phân định mới, nhưng chưa ai hiểu lý do vì sao Trung Quốc lại công bố đường cơ sở mới vào thời điểm này. Để trấn an Hà Nội, bộ Ngoại giao Trung Quốc khẳng định đường cơ sở mới được vạch ra “sẽ không tác động tiêu cực đến lợi ích của Việt Nam hay của bất kỳ quốc gia nào khác”, mà trái lại, “sẽ thúc đẩy hợp tác hàng hải quốc tế giữa Trung Quốc và các nước liên quan và đóng góp vào sự phát triển chung của hàng hải toàn cầu”.Nhưng trong tuyên bố ngày 14/03, phát ngôn viên bộ Ngoại Giao Việt Nam Phạm Thu Hằng đã chỉ trích việc chính phủ Trung Quốc đưa ra 7 "điểm cơ sở" khi nối với nhau tạo thành một đường cơ sở mới nhằm tuyên bố "lãnh hải" ở Vịnh Bắc Bộ. Theo phát ngôn viên bộ Ngoại Giao, "các điểm này không tồn tại trong 49 điểm cơ sở mà Trung Quốc công bố ngày 15/5/1996 để tính chiều rộng lãnh hải từ Hải Nam tới Thanh Đảo".Bà Hằng cho biết Việt Nam "đã và sẽ tiếp tục trao đổi quan điểm với Trung Quốc về vấn đề này trên tinh thần hữu nghị, hiểu biết và tôn trọng lẫn nhau".Nhà nghiên cứu Hoàng Việt nhận định về những phản ứng nói trên của Việt Nam: "Đây là tuyên bố thường thấy của Việt Nam. Có lẻ vì thấy dư luận đang thắc mắc và có những ý kiến lo ngại về đường cơ sở mới của Trung Quốc ở Vịnh Bắc Bộ, nên Việt Nam buộc phải lên tiếng. Phát biểu này không có gì mới hơn so với những gì mà Việt Nam và Trung Quốc đã cam kết thực hiện. Việt Nam vẫn luôn kêu gọi Trung Quốc phải tuân thủ Công ước về Luật Biển 1982.Nhưng như đã nói ở trên, đường cơ sở thẳng mà Trung Quốc công bố có lẽ có một số điểm chưa phù hợp với tinh thần Công ước về Luật Biển. So với đường cơ sở thẳng mà Trung Quốc công bố năm 1996, thì đường cơ sở mới bao trọn eo biển Quỳnh Châu, hay còn gọi là eo biển Hải Nam nằm trong nội thủy của Trung Quốc. Cái này cũng không phải là mới, vì trước đây, từ năm 1958, đến năm 1992 và đến khi công bố đường cơ sở năm 1996, Trung Quốc cũng đã từng tuyên bố eo biển Quỳnh Châu nằm trong nội thủy Trung Quốc.Năm 1996, Trung Quốc đã từng tuyên bố đường cơ sở có hai hệ thống, một hệ thống nằm trong thềm lục địa của Trung Quốc và kéo dài đến đảo Hải Nam, hệ thống thứ hai là đường cơ sở thẳng bao quanh quần đảo Hoàng Sa. Năm đó thì Việt Nam đã ra tuyên bố phản đối với hệ thống đường cơ sở thẳng bao quanh Hoàng Sa, vì nó không hoàn toàn phù hợp với Công ước về Luật Biển năm 1982. Tuyên bố của phát ngôn viên bộ Ngoại Giao cũng đã nhắc lại phản đối này."Shashank S. Patel, một nhà phân tích địa chính trị theo dõi sát các hoạt động ở Ấn Độ Dương-Thái Bình Dương, nhận định với EurAsian Times: “Việc công bố một đường cơ sở mới có vẻ quá đáng trên bản đồ sẽ tác động sâu hơn đến vùng đặc quyền kinh tế và vùng tiếp giáp lãnh hải của Việt Nam, nơi cung cấp các vùng đánh cá chính cho Trung Quốc.”Ông nói: “Việc đơn phương phân định đường cơ sở mới của Trung Quốc là một nỗ lực nhằm hạn chế các yêu sách của Hà Nội đối với vùng đặc quyền kinh tế của Việt Nam và các vùng nước sâu. Khu vực nằm trong đường cơ sở mới của Trung Quốc chiếm hơn 60% diện tích, vi phạm trắng trợn Công ước UNCLOS. Hy vọng Việt Nam không để vấn đề này leo thang lên mức cao nhất, nhưng nếu không làm như vậy sẽ ảnh hưởng đến quyền đánh bắt cá, chuỗi cung ứng và tuyến đường biển của Việt Nam trong thời gian tới”.Nhưng đối với nhà nghiên cứu Hoàng Việt, đường cơ sở mới mà Trung Quốc vừa công bố không làm thay đổi những gì đã được phân định giữa hai nước: "Với câu hỏi nó có tác động gì hay không thì tôi trả lời là không, bởi vì hai bên đã ký kết Hiệp định Phân định Vịnh Bắc Bộ từ năm 2000, có hiệu lực từ 2004, tức là 20 năm rồi. Dù Trung Quốc có vẽ đường cơ sở nào đi chăng nữa thì nó cũng không làm thay đổi sự phân định giữa hai bên theo hiệp định năm 2000. Tôi đã đọc một số ý kiến cho là Trung Quốc có mưu đồ lấn chiếm, nhưng tôi nghĩ Trung Quốc không thể lấn chiếm được khi Vịnh Bắc Bộ đã được phân định rõ ràng rồiHiệp định đã phân định xong rồi. Trung Quốc có quyền tuyên bố một đường cơ sở trong khu vực của họ. Và ngược lại, Việt Nam cũng có quyền tuyên bố một đường cơ sở trong phần của Việt Nam ở Vịnh Bắc Bộ. Hiện nay, ngoài đường cơ sở thẳng mà Việt Nam tuyên bố tháng 11/1982, cũng cần phải tuyên bố thêm, như nhắc nhở của một số người trước đây, vì đường cơ sở thẳng của Việt Nam chưa được khép kín, khi còn bỏ trống một điểm cơ sở ở khu vực trong Vịnh Thái Lan vào khu vực Vịnh Bắc Bộ. Hai nơi này chưa được phân định. Khu vực Vịnh Bắc Bộ đã phân định từ rất lâu mà Việt Nam vẫn chưa công bố một đường cơ sở trong vùng biển này. Nếu hỏi hai bên có thể đàm phán lại được hay không, thì câu trả lời là “không thể”, bởi vì hai bên đã đàm phán xong rồi và đàm phán đã rất là khó khăn, và muốn thay đổi gì thì phải có sự đồng ý của hai bên. Một điều khoản trong Hiệp định Phân định Vịnh Bắc Bộ nói rõ như vậy. Tôi nghĩ rằng khả năng thay đổi rất khó vì Việt Nam không muốn thay đổi, mà Trung Quốc chắc cũng không muốn thay đổi. Điều này cho thấy là Việt Nam cũng phải sớm tuyên bố một đường cơ sở ở Vịnh Bắc Bộ trong khu vực của Việt Nam để bảo đảm quyền và lợi ích hợp pháp của Việt Nam ở vùng biển này.".Nhưng nhìn vấn đề xa hơn, trên trang mạng EurAsian Times, nhà phân tích Patel nhấn mạnh: "Đường cơ sở mới có thể cản trở quyền tự do hàng hải, nghiên cứu khoa học, lắp đặt cáp và đường ống cũng như các nỗ lực cải tạo đảo". Patel lưu ý: “Nếu Việt Nam, theo đường lối của Philippines, đưa vấn đề ra Tòa Trọng tài Thường trực, Trung Quốc sẽ lại bác bỏ phán quyết, cho rằng phán quyết đó bất hợp pháp và vô hiệu.”   

What's the difference between education and training? Why is the distinction important? How does the Deming lens offer a new perspective on teacher effectiveness? In this episode, John Dues and host Andrew Stotz talk about why it's important to go beyond skills training and encourage education for personal growth.  TRANSCRIPT 0:00:00.0 Andrew Stotz: Here we go. My name is Andrew Stotz, and I'll be your host as we continue our journey into the teachings of Dr. W Edwards Deming. Today I'm continuing my discussion with John Dues, who is part of the new generation of educators striving to apply Dr. Deming's principles to unleash student joy in learning. This is episode 19 and we're continuing our discussion about the shift from management myths to principles for the transformation of school systems. John, take it away.   0:00:31.2 John Dues: Andrew, good to be back. Yeah, principle 13 today, Institute a Vigorous Program of Education. I'll just start by reading the Principle, "Institute a vigorous program of education and encourage self-improvement for everyone. The school system needs not just good people, but people that are improving with education. Advances in teaching and learning processes will have their roots in knowledge." It's interesting, when I was reading about sort of this particular principle, Dr. Deming took this actually pretty far when he was asked where would you draw the line? And he basically said, I would allow any educational pursuits that people are interested in. So that was his sort of take on this particular principle. But I think it's maybe the first thing is to differentiate between training and education. When he was talking about those things, we talked about instituting training on the job back when we talked about principle six, and he basically said the training is for a skill and a skill is something that's finite because it ends when performance has reached a stable state for a person when thinking about that particular skill.   0:01:51.3 JD: The differentiator with Principle 13 is that it's focused on education and it's meant for growth. And in the Deming philosophy, this is sort of a never ending process of education. So skills, so training is focused on skills, whereas education is focused on knowledge and theory. And this is really an important distinction in my mind, and you need both, training and education are complimentary components I think of an effective school system or really an effective organization in general. So I think, I mean, obviously training is important. It's something that's necessary, especially when you come into a new job. We have lots of new teachers that come to us 'cause we're a relatively young organization. And it's pretty typical for these new teachers to come even if they majored in education many times, they don't have sort of the basic classroom management skills, the basic lesson planning skills, the basic lesson delivery skills that they need to be successful in the classroom.   0:03:00.9 JD: So we have a training program, and in the absence of that training program the teachers would probably flounder or it would take a lot longer time to get their legs under them. So training is important, but we have to sort of shorten that runway. So we have to be good at training 'cause we're like a relatively young organization and we have students that come to us on average that are below grade level. And so they can't wait a long time for these sort of teachers to get up to speed. And I think we've talked about the fact that we have this sort of three week training program before the school year starts for new teachers for that reason. And so training is obviously important, very important. But I think what I've sort of come to appreciate is this idea of... And Deming stressed this, that leaders, systems leaders understand this idea of a stable system.   0:04:00.7 JD: One of the things that he said was that "The performance of anyone that can learn a skill will come to a stable state upon which further lessons will not bring improvement of performance." And this for me, reading Deming at this point in my career was really an interesting revelation because for many years I had heard sort of policymakers, education reform types sort of lament the fact that teachers improvement largely levels off in about year five of their career. Now, there has been some more recent longitudinal teacher research in terms of effectiveness over time. And basically people have found that that's not quite true. And that teaching experience is positively correlated with student achievement gains sort of across the teacher's career. But it's definitely true that the gains and effectiveness are steepest in those initial years.   0:04:55.2 JD: And so when you put those two ideas together that there's sort of this leveling off in about year five with Deming's sort of concept of stable systems, it really sort of dawned on me that it was this perfect explanation for this phenomenon. When a teacher is in their first five years there's a lot of foundational skills like the things I was talking about, like lesson planning, lesson delivery, classroom management, those basic things. There's sort of this period of rapid improvement or growth, and then it sort of levels off after you get the basics of how to be a teacher. And then after that happens, you have this... The potential for improvement sort of lies within the organization, within the system itself and not in the individual. So this really lined up with this thing I had heard for a long time, even though I think sort of it was misinterpreted.   0:05:52.0 JD: And I think a lot of those people that were talking about teacher skills leveling off after five years, they didn't have this lens of a stable system. They didn't have that part of it. And so they were saying, well, teachers aren't improving. Well, it really wasn't the teachers not improving. It was the fact that most of the capacity, like we've talked about here for improvement lies within the system itself and not the individuals. And I would also make the argument that this is not just educators, that this is other sectors as well, healthcare or whatever that thing is.   0:06:27.0 AS: Yeah. I mean, a good way of imagining that is a person who knows nothing that has the prerequisites, the education or whatever's necessary to get the job. And they know nothing about teaching and about the school system or anything that you can just imagine that so much of the initial phase is just understanding how the system, how they operate within that system to do certain tasks, which can be a process of trying to understand all of that. But then it's like they become, it's like entering the stream and then they become the stream floating down the river where everybody's kind of doing the same thing. And then you realize, okay, by this time now their, their, the amount that they can improve has been hit for some specific tasks and things like that. And then all of a sudden their output is a function of the system.   0:07:23.0 JD: Yeah. Yeah. And I think where this can really go off the rails is when people don't understand the stable state of systems. I think that, and I think a lot of the educators from reformers were sort of talking about it as if teachers were kind of replaceable because they didn't improve after those initial five years, especially 10 years ago that was sort of the common way people talked about this. And you could then sort of the next step is to draw the conclusion that experienced educators aren't that important since that improvement sort of levels off pretty early in their career. But I think that is the completely wrong conclusion to draw. I think experienced teachers are incredibly important because of the stability they provide a school. They can provide mentorship to inexperienced teachers, they have longstanding relationships with families as multiple students come through the system.   0:08:25.0 JD: That stability is really important for all those reasons, which are hopefully fairly obvious to anybody that's worked in a school. But I think even maybe more importantly is this idea that once teachers have that baseline level of knowledge and skills, they can run a classroom, they can deliver a well-planned lesson. The reason that it then becomes important for improvement to have those folks is because once those basic things are in place, now we can actually start to work on the system where the real potential for improvement lies. And I think that was a point that was missed or glossed over in a lot of those conversations about education reform and this idea of the teacher skills leveling off after year five.   0:09:23.8 AS: Mm-hmm. One of the the things about education that I have a story that's... I guess one of the conclusions is that the next level of improvement of the system oftentimes comes from outside the system. And that's where education takes the mind into another space.   0:09:40.9 JD: Yeah.   0:09:49.2 AS: From that other space, they're getting knowledge and theories of what's going on out there. And I had an example, John, that was... When I was the head of research at Citibank, and I had been head of research before taking care of a team of analysts, and analysts are always late in their reports, they're writing long reports about whether to buy or sell a company. They're trying to gather as much information, talk to the company, things get delayed. They set their deadlines and then they... The job of a head of research is juggling those delays so that the sales team and the clients need an idea day. And it's always the case that you're juggling around and okay, we don't have something this day, let's make something up with what we've got. Okay, this guy couldn't produce on that day, but he's gonna come in on Monday. So I felt pretty good about my skills at managing that process. And then I got a job at the number one foreign, the number one broker, let's say, or investment bank at that time in Asia called CLSA. And when I talked to them, I asked them how do you handle the flow and how bad is it here [chuckle] with the analysts being late? And they said, the analysts are never late.   0:11:13.3 AS: And I was like, that's impossible. My whole career it's been about handling the analysts being late. And they said, no, analysts are never late here. And I was like, how are you doing that? And they're like, well, we have a three week plan ahead. Everybody knows it. You know your day. There is no excuse, there's no shifting, there's nothing, it has to be delivered on that day. So it's up to you to kind of bring your project to a head so that you're ready to present on that day. And if you have some kind of major setback or problem, talk to another person and switch the day with them and sort it out. And every single day we had great stuff coming out. And I would've never, I mean, I was operating at a certain level thinking I was really knocking it out of the park, 'cause I was accommodating. I was careful, I was thoughtful. I understood the pressures that people were feeling. I was doing my best, but I didn't have a knowledge that it could be a very different way of doing it. And that's where I think about going outside of your own system to observe and learn and see. And then all of a sudden you're like, oh, [laughter] Okay. And that's where I feel like what you're talking about, about the education aspect is really the most amazing part.   0:12:33.2 JD: Mm-hmm. Yeah. That actually... I hadn't planned to talk about this, but I've been reading recently about the... Called the... Well, there's a book called Toyota Kata and Kata is from martial arts. It's the various movements that you have to do sort of repeated deliberate practice so you can sort of, they become ingrained in your muscle memory. Well, the same idea is in place in Toyota. They call... Well, they don't, but the author called it... They don't call... They don't have a name for it, but he sort of observed it and gave it the Improvement Kata name Mike Rother. Yeah, there it is. Yep. There it is. That one. And one of the things that was interesting, and it kind of reminded me of this as you were talking, is that part of the improvement kata is there's a sort of a target that's aligned with the organization's vision that guides anything that the folks in the organization are working towards.   0:13:27.0 JD: And so there's always a target condition. There's an understanding of sort of where each individual is and the departments are. And they're always setting a new target on the way to that sort of vision target and running these experiments all the time. And they constantly set those targets so that they are ambitious but within reach. And then they're coached on the way repeatedly. And in that way they're sort of always moving forward the organization. And so I think of when you've changed investment banks and you're at this new bank and they're saying, Hey, this thing is possible, it's possible to do this. Here's the way we do that. Here's how we work towards that. And so you can imagine a place like Toyota being so successful, because if everybody has got this mindset, this scientific thinking where they're constantly moving towards a target and there's a method for doing so, [chuckle] that is an incredible education right there if you're an employee working in an environment like that. So that just made me think of the Toyota Kata.   0:14:41.4 AS: Yeah. And it's a great example of how reading books is part of education because you're getting exposed to new ideas and exploring and thinking about things. And that's where, well, think about the repetition in let's say a martial arts as an example. And when Dr. Deming talks about opening up education to everything for everybody, there's something to learn in almost everything out there. Like if it is about... What is it about those repetitions and why is that important and could that benefit our business? And he talked about painting and other things, you know? Like education very widely can bring you new ideas that can come back to improve your system.   0:15:27.3 JD: Yeah. And I think you have to invest in that sort of broader education, 'cause it's sort of an investment in the future, you know? Especially right now, things are changing fast. And you could have the best training program in the world, but if you are not also sort of looking out for what's next beyond that, to adapt to whatever's changing in your environment... A good example is this, we have a much better understanding of cognitive science than we did 20 years ago. And so if we didn't adapt... If we didn't sort of learn that and then adapt that and sort of include that learning in our training system that we're gonna start falling behind pretty quickly. And I think this can get... This may be part of the most important responsibility of a leader on the learning front.   0:16:28.5 JD: Because what I also see is that education leaders are often getting enticed by many, many fads that sort of come along. And so how to sort of actually latch onto something that represents a potential advantage, that's a real important skillset to have. And I don't think... That's a key... I think a key function of systems leaders is sort of to know what to let go of or what not to latch onto at all and what to sort of sink resources into because if you're gonna go do these educational pursuits, you're obviously gonna have to sink time and money resources into these things. And so being able to differentiate between what is good and what is bad is a real key skill.   0:17:22.6 AS: And one of the things about Toyota is it's like the ultimate Asian family business. And although it's now a big public company, the largest automaker in the world, and the family's ownings in the company is relatively low, it still has the influence of the family. And I was thinking about another huge company that I know of in Thailand here that shifted its focus away from, let's say, Deming in this case, to when a new CEO came in, he said, well, there's a different way and this is my way. And one of the things that's interesting about what Toyota's done, you know, Toyota gets a lot of blame for being slow to progress and stubborn and all of that, but man, they have built a machine and a... You just can't change the direction of that quickly, you really nurture what has been developed and how do you not just throw away. I was presenting to my students last night in my finance class here at Sasin School of Management in Thailand and I was showing them the DuPont Analysis in the world of finances where you break down the return on equity of a company. And I explained why they call it the DuPont Analysis, and that's because the DuPont company bought shares in General Motors in 20- or 1912 or something like that and they instituted this method of financial controls on General Motors. And I said to my students in passing, General Motors has been going bankrupt since 1912.   [laughter]   0:19:00.9 AS: And it's like every... It's not a cumulative level of learning. And that's where I feel like Toyota, what Toyota has achieved is a cumulative learning process.   0:19:16.9 JD: Mm-hmm. Yeah. You know, and it's a part of their DNA. I think certainly there have been challenges as they've grown across Europe and the United States and the world really. And a lot of the challenges that I understand is because people... That improvement Kata is sort of combined with a coaching Kata, like an approach to coaching and managers at different levels coach folks that are sort of a level down from them. And everybody in the organization, especially early, had sort of this mentor-mentee relationship. And so part of the challenge with growth was the fact that there are only so many of these folks that are grounded in this scientific thinking in the coaching part of this. And so that was a challenge as they grew, you know, in California and Kentucky and other places across the world.   0:20:17.9 JD: They had to build this coaching capacity across all of these new production facilities and other types of facilities across the world. So... But I think that what I really like about this principle...I, you know, if push came to shove, I started this by talking about Deming would basically allow almost anything when it came to allowable educational pursuits. And I think I would be much closer to that than I would be to limit those things. I think that is a really... That's a good sort of approach to take as a leader. I think here where I am at United Schools Network, one of the things that I was able to do was go take an improvement advisor course which required significant resources and time and money at the Institute for Healthcare Improvement.   0:21:19.6 JD: And so someone could look at that very easily and say, well, why are you an educator going to a healthcare organization? And I think it's one of those things where people maybe don't realize that the Deming philosophy and some of the continual improvement stuff, it's sector agnostic. And so when you can learn the philosophy, the methods, the techniques, you can bring them back to your own organization. So I think had I not gone down this path to study Deming, I wouldn't have made it to IHI and then bring this stuff back to my organization. I think it's benefited our organization in lots of ways, even though that might not have been immediately apparent to folks, you know, initially.   0:22:09.8 AS: So how would we wrap this up for the listeners to make sure that they truly understand the idea of vigorous education, self-improvement, this type of stuff?   0:22:14.0 JD: Yeah. I mean, for me the main point is that systems leaders should really encourage education among the whole workforce with a pretty wide latitude for allowable pursuits. I think especially for educators, when we seek those types of opportunities, we're also modeling this idea of continual learning to students as well. They see that just because I have a degree or a master's degree or even folks here that have a PhD, we have I think an organization that's pretty hungry for learning. And that's a model for students. Oh, this doesn't end when you graduate high school. This doesn't end when you graduate college. It doesn't even end when you graduate from graduate school. People all across the organization have books piled up on their desks and we're sending people to various learning programs and stuff like that.   0:23:09.4 JD: And I think that's a good model for students. And I think within that another big thing is to think about do you have an understanding of the stable state of systems and understanding that training programs are only gonna take you so far? Individuals are gonna come to a sort of a stable state once they've sort of maxed out on any particular skill. And that's why this idea of education is so important. Skills are important, training is important, but this other side of the coin, you have to pay attention to education. What's on the horizon? How are you gonna push the boundaries within your system? And I actually think to your point about outsiders or having an outside perspective, that's sort of, I think the benefit of education, because I think without that sort of push from an outsider, the push from the education, breakthrough improvements aren't possible in our school systems. They're not gonna come from training programs. They're gonna come from this continuous learning, this idea of continually pushing the targets, having sort of an improvement mindset. Having a coaching mindset that's always pushing towards those things. And I think this requires not just skills, but it requires new knowledge and new theory continually. And I think that has to come from this vigorous program of education.   0:24:39.7 AS: And the beauty of capitalism is that if you don't go out and get the education, your competitors will, and you don't want your source of learning to be facing constant defeat from your competitors.   [laughter]   0:24:56.2 JD: Yeah, you can't sit around and wait, that's for sure. That's for sure.   0:25:00.0 AS: Exactly. Or someone's gonna take it. And that's the beauty of the capitalist system, the adversarial aspect between companies definitely gets people riled up when they see that all of a sudden someone's doing much better with some new technique or idea. Well, I think that was a great discussion to help us understand the difference between training and education and why it's so important. John, on behalf of everyone at the Deming Institute, I want to thank you again for this discussion. For listeners, remember to go to deming.org to continue your journey. You can find John's book "Win-Win: W. Edwards Deming, the System of Profound Knowledge and the Science of Improving Schools" on amazon.com. This is your host, Andrew Stotz. And I'll leave you with one of my favorite quotes from Dr. Deming. "People are entitled to joy in work."  

Neste episódio, o Dr. Lucas Zambon, Diretor Científico do IBSP, analisa os principais pontos de uma entrevista publicada pelo New England Journal of Medicine/NEJM Catalyst 2023, na qual Kedar S. Mate, CEO do IHI revela suas opiniões sobre os dados atuais da Segurança do Paciente.#IBSP #SegurançaDoPaciente #PodCast #IBSPPodcast #NovoEpisódio #NEJM #Dados #patientsafety

This episode of “Inside Health Care: a Podcast by NCQA” features three interviews recorded live at our Health Innovation Summit in October 2023. Among many panels and presentations was an incredible session titled “Health Equity Trailblazers: Where Vision Meets Commitment.” Health equity leaders discussed their organizations' health equity strategies, vision and lessons learned, delving into how leaders can commit to and advance health equity priorities. Each of this episode's guests sat on that panel then sat with me for a deeper dive. These leaders, each in their own way, want to inspire us to action.Dr. Joneigh Khaldun is Vice President and Chief Health Equity Officer for CVS Health. In this role, she advances the company's data-driven strategy to improve access to services, address social determinants of health and decrease health disparities. She is a sought-after speaker and thought leader who has appeared on Meet the Press, MSNBC and CNN, among others, and she has testified before Congress.In her past work, as the top doctor leading Michigan's COVID response, she is credited with the state's early identification of and actions to decrease disparities, and in 2021 was appointed by President Biden to the national COVID-19 Health Equity Task Force. She is a practicing emergency physician who earned her MD from the Perelman School of Medicine at the University of Pennsylvania.Dr. Ronald M. Wyatt is a renowned global health care quality and safety expert with a passion for advancing health equity worldwide. Dr. Wyatt is Founder and CEO of Achieving Health Equity, LLC. As a distinguished Senior Fellow with the Institute for Healthcare Improvement, he holds pivotal roles as Chief Science Officer and Chief Medical Officer at the Society to Improve Diagnosis in Medicine, an organization dedicated to enhancing diagnostic accuracy in health care. As an expert in hospital safety oversight, Dr. Wyatt holds a significant role in shaping the National Patient Safety Goal on Health Equity. His contributions to the National Patient Safety Plan, authored by AHRQ and IHI, underscore his commitment to advancing health care on a global scale.Dr. Bryan O. Buckley moderated the Health Care Trailblazers panel at NCQA's 2nd annual Health Innovation Summit. Dr. Buckley is NCQA's Director for Health Equity Initiatives. In this position, he plays a key role in developing partnerships with funding and research organizations, care delivery systems, the managed care industry and communities to translate research knowledge and real-world evidence into development of equity-oriented products and programs. These include NCQA's Health Equity Accreditation programs.

Healthcare is inherently risky and so as child health professionals we need to make patient safety a priority in all our actions. We need to think about safety all the time.  In episode 1 of our six-part series on paediatric patient safety, we speak with Dr Peter Lachman, who develops and delivers programmes for clinical leaders in quality improvement at the Royal College of Physicians in Dublin. As Peter explains on the podcast, we healthcare professionals need to know patient safety theory - but, more importantly, we need to know how to apply it, drive improvement and create a workplace culture that fosters safe working practices. Everyone - from the most junior member of the team to the most senior paediatric clinical leader - needs to think about patient safety all day every day. A safe culture takes time to build. Shared activities such as handover, huddles and debrief can model good behaviour and benefit performance. Repeating behaviours that represent a safe culture can create a virtuous cycle which can change deeply held attitudes and beliefs, then ultimately the safe culture overall. Thank you for listening. Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber RCPCH Head of Quality Improvement Produced by 18Sixty Please be advised that this series contains stories relating to child death and harm. All views, thoughts and opinions expressed in this podcast series belong to the guests and not necessarily to their employer, linked organisations or RCPCH. Download transcript (PDF) About the Patient safety podcast series As doctors we ‘first, do no harm'. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings. We hope you will be entertained, educated, and energised to make strides in improving the safety of the children that you care for. There are lots of resources that expand on this on the RCPCH Patient Safety Portal, including the theory of patient safety culture and examples of how people across the UK are doing this well. Visit at https://safety.rcpch.ac.uk. More about Dr Peter Lachman Dr Peter Lachman develops and delivers programmes to develop clinical leaders in quality improvement at the Royal College of Physicians in Dublin. He works with HSE Global in Africa, and he was Chief Executive Officer of the International Society for Quality in Healthcare (ISQua) from 1 May 2016 to 30 April 2021. Peter was a Health Foundation Quality Improvement Fellow at IHI in 2005-2006 and then went on to be the Deputy Medical Director with the lead for Patient Safety at Great Ormond Street Hospital 2006-2016. Peter was also a Consultant Paediatrician at the Royal Free Hospital in London specialising in the challenge of long-term conditions for children. Peter is the lead editor of the OUP Handbook on Patient Safety published in April 2022; Co-Editor of the OUP Handbook on Medical Leadership and Management published in December 2022; and Editor of the OUP Handbook on Quality Improvement to be published in 2024. Topics/organisations/papers referenced in this podcast ISQUA (International Society for Quality in Healthcare) Oxford Professional Practice: Handbook Of Patient Safety IHI (Institute for Health Improvement) Human factors - on RCPCH Patient Safety Portal S.A.F.E. Collaborative - on RCPCH Patient Safety Portal Cincinnati Childrens Hospital patient safety Paediatric Early Warning System (NHS England) BMJ Quality & Safety journal Lachman, P., Linkson, L., Evans, T., Clausen, H., & Hothi, D. (2015). Developing person-centred analysis of harm in a paediatric hospital: a quality improvement report. BMJ quality & safety, 24(5), 337–344 Health Foundation A framework for measuring quality, with Professor Charles Vincent et al WellChild: the national charity for sick children Applied human factors - on RCPCH Patient Safety Portal 5 whys SEIPS (Systems Engineering Initiative for Patient Safety) Psychological safety- on RCPCH Patient Safety Portal Situational awareness - on RCPCH Patient Safety Portal MaPSaF (Manchester Patient Safety Awareness Framework) Top Gun Irish Certificate in Essential Leadership for New Consultants Rolfe et al's reflective model (PDF) (what now what so what) NHS England: Improving patient safety - a practical guide

Our focus on reducing disparities led to a partnership with the Institute for Healthcare Improvement. A gap in care with our Somali patient population was discovered after reviewing numbers for colorectal and breast cancer screenings, pediatric immunizations and diabetes. Two HealthPartners colleagues, family nurse practitioner Munira MaalimIsaq and senior project manager Greg Fedio, share how the Equity Action Lab project helped assess and better understand the gaps and determine steps for changes.Hosts: Kari Haley, MD, and Steven Jackson, MDGuests: Munira MaalimIsaq, FNP; and Greg FedioHealthPartners website: Off the Charts podcastGot an idea? Have thoughts to share? We want to hear from you. Email us at offthecharts@healthpartners.com.

On episode 94 of PSQH: The Podcast, Patricia McGaffigan, vice president of the Institute for Healthcare Improvement, and Dina Dent, vice president and chief nursing officer, at Inova Health System, talk about the IHI's nurse-led pilot rapid-cycle improvement program.

In today's episode on National Rural Health Day, I speak with two physicians with extensive experience providing patient care in rural environments. We talk about human trafficking, the opioid epidemic, rural healthcare access, and more. Hanni Stoklosa, MD, MPH, Chief Medical Officer and Co-Founder of HEAL Trafficking, is an emergency physician at Brigham and Women's Hospital (BWH) with appointments at Harvard Medical School and the Harvard Humanitarian Initiative. She is an internationally-recognized expert, advocate, researcher, and speaker on the wellbeing of trafficking survivors in the U.S. and internationally through a public health lens. She has advised the United Nations, International Organization for Migration, U.S. Department of Health and Human Services, U.S. Department of Labor, U.S. Department of State, and the National Academy of Medicine on issues of human trafficking and testified as an expert witness multiple times before the U.S. Congress.  Eileen D. Barrett, M.D., MPH, SFHM, MACP, is Chair of the Board of Regents of the American College of Physicians (ACP), representing internal medicine physicians, related sub specialists, and medical students. She is a rural internal medicine hospitalist and Faculty with IHI. Dr Barrett She completed a Rural Faculty Development Fellowship through the University of Arizona in 2009 and a Medical Justice and Advocacy Fellowship through Morehouse School of Medicine and the American Medical Association in 2022.

From communal Ihi and Dashain-Tihar gatherings to workshops on family violence and overcoming addictions: stay informed on the activities happening in Australia's Nepali community. - सामूहिक ईही र दसैँ-तिहार भेटघाटदेखि कुलतबाट छुटकारा पाउने अनलाइन कार्यशालासम्म - अस्ट्रेलियाका विभिन्न राज्य तथा प्रदेशमा छरिएर बसेका नेपाली समुदायमा कहाँ के कार्यक्रम हुँदै छन्? सामुदायिक गतिविधिका बारेमा सुन्नुहोस्।

¡Increíble! Porque no, no es el mejor deportivo de Ferrari… ¡es el mejor deportivo de la historia! Y no, no es cosa mía, expertos que saben más que yo y que han probado más coches que yo coinciden en esto. Y es que el F40 tiene características únicas: Es una idea de Enzo y es el último Ferrari diseñado bajo la estricta batuta de “Il Commendatore”. En 1986 Enzo no era feliz. O al menos no del todo. ¿El motivo? No era uno, sino dos, con nombre, Porsche y Lamborghini, y apellidos, 959 y Countach 5000 QV. Dos coches más sofisticados y rápidos que los Ferrari del momento y con mucha capacidad de seducción… Que Porsche superase a Ferrari, Enzo, lo llevaba mal, pero que el “Maldito” Ferrucio Lamborghini hiciese un coche más rápido era, sencillamente, IN-TO-LE-RA-BLE. Enzo en 1986 tenía 88 años y no quería morirse sin solucionar este “problemilla”. Así que llamó a su ingeniero de confianza, Nicola Materazzi y le dijo sencillamente que quería diseñar el mejor deportivo del momento, que superase al 959 y al Countach no solo en prestaciones, sino en tecnología, atractivo y personalidad. Materazzi pensó en cuál podría ser la mejor base de partida para hacer el mejor deportivo de la historia… un coche de carreras que pudiese matricularse… ¿Y qué tal partir de un coche de Grupo B? No era mala idea. Ferrari había homologado en Grupo B nada menos que el 288 GTO Evoluzione… pero luego el Grupo B desapareció y 5 unidades perfectamente preparadas se quedaron guardadas en los almacenes de Maranello. Al partir de un coche de competición se heredaron cosas como el chasis tubular y el motor V8. Ferrari sentía que el punto fuerte de su marca eran los motores. De hecho, una frase célebre de Enzo era: “Vendo motores… el coche lo regalo, porque el motor tiene que ir en algún sitio”. Un crack. Pero es que además el motor más característico de Ferrari es el V12… y el GTO llevaba un V8. Pero un V12 era más grande y pesado y, gracias a la tecnología Turbo, no era necesario para conseguir la potencia que se quería, próxima a los 500 CV. Imagino la de argumentos que tuvo que utilizar el pobre Materazzi para convencer a su jefe… ¡pero le convenció! Heredar el motor del GTO Evolucione no fue mala cosa, pues el V8 de 2.936 cm3, 4 árboles de levas en cabeza, 32 válvulas y doble turbo IHI, ofrecía en la versión definitiva del F40 nada menos que 478 CV a 7.000 rpm. Siguiendo las instrucciones de “Il Commendatore” el coche no tenía ninguna ayuda a la conducción… y ninguna es ninguna… ni servofreno, ni servodirección, ni cambio secuencial, ni siquiera antibloqueo de frenos ABS. La genialidad del diseño de Leonardo Fioravanti quedó patente, ha quedado patente, en el F40. No voy a hablar de la estética del coche porque, sinceramente, no me siento capaz de ser objetivo. Pero detalles como el frontal o el capo trasero que deja ver el motor y con sus branquias de ventilación, crearon escuela. Pero no solo eso, sino que el CX era de solo 0,34 algo muy bueno para un deportivo, porque no es fácil conseguir una buena penetración en el aire y, además, una buena “carga aerodinámica”. Imagino que todos sabéis lo que es la relación peso/potencia, es el número de kilos que tiene que arrastrar cada caballo, que es de 2,3 kg(CV en el F40. Pensemos en un buen deportivo actual, ¿Qué te parece un Porsche 911 Carrera? Es un coche que según todas las pruebas que puedas leer, es un “tiro” gracias a sus 385 CV… y pesa 1.545 Kg. Eso es una relación peso/potencia de 4,01 kg para cada caballo… ¡casi el doble que el F40! No te fíes del número de caballos. Vámonos al límite, el Bugatti Veyron de 1.001 CV. Pues pesaba 2.000 kg, así que la relación peso potencia era de 2 kg por caballo. Ligeramente mejor que la del F40… pero cuando llegan las curvas o las frenadas… ¡nada que ver! Enzo lo tenía claro: El peso era prioritario y por eso no montó ningún elemento de confort… salvo el A/A, con buen criterio en mi opinión. A mí el interior del F40 me parece sencillamente espectacular. Los asientos auténticos “bacquets” de competición, la postura y posición frente al volante, perfectas y la visibilidad, para ser el coche que es, muy buena hacia delante y los lados… ¿Y hacia atrás? Pues mala o muy mala, pero ¿qué importa? Nadie te va a alcanzar, eso seguro. El coche fue un éxito increíble: Solo se pensaban hacer 400, que no iban a ser fáciles de vender, y se fabricaron 1.315 unidades. Cuando se vendieron en España su precio era de 40 millones de pesetas, unos 240.000 euros...un 50 por ciento más caro que el Ferrari más caro hasta ese momento. ¡Ese precio sería hoy en día un negociazo!

"This is the time for a different kind of leader" — Dr Kedar Mate, President and CEO of the Institue for Healthcare ImprovementIn this episode, President and CEO of the IHI, Dr Kedar Mate begins by reflecting on his upbringing and the formative years that impact his values. While working for Partners in Health, he saw first-hand how solving a complex problem in Peru helped him to understand values and complex systems. He goes on to highlight the importance of using values-based leadership and the utility of the Quality Improvement (QI) skill set. Next, Dr Mate elaborates on some of the challenges with QI, as well as some of the successes with nationwide healthcare models. We conclude with his reflections on taking on the role as the leader of the Institute for Healthcare Improvement (IHI) and the importance of self-care.Follow Dr Kedar Mate: Twitter/X, Linkedin.About the guest; Kedar Mate, MD, is the President and Chief Executive Officer at the Institute for Healthcare Improvement (IHI) and a member of the faculty at Weill Cornell Medical College. Dr. Mate's scholarly work has focused on healthcare quality, strategies for achieving large-scale change, and approaches to improving health equity and value.Resources mentioned in the podcast:Dr Mate's podcast Turn on the lightsThe Institution for Healthcare Improvement Basics of Quality Improvement - The Science of Improvement Plan-Do-Study-Act (PDSA) CyclePartners in Health WebsiteNetflix Documentary on Partners in Health - Bending the ArcBackground of Dr. Paul FarmerMusic attribution: AudioCoffee from Pixabay.Contact information: If you'd like to get in touch, reach out at jono@clinicalchangemakers.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.clinicalchangemakers.com

This week I am joined by Dr Ihirangi (Ihi) HekeIhi is an honorary research fellow to the University of Auckland and has been working with Johns Hopkins University  to conduct a study using traditional indigenous health approaches alongside Systems Dynamics. Ihi is also working with Washington University in the development of training programmes exchanging Systems Dynamics from indigenous and non-indigenous perspectives.Over the past 10 years he has been active in helping Māori and other indigenous groups abroad, build their own health and wellness activities based on their own traditional knowledge. His Atua-Matua Framework has been a work in progress and is attracting national and international attention from health and education policy makers and providers who are struggling to apply standard western deficit models to global health initiatives and are looking to more localised indigenous models of engagement to deal with global health issues. Support the show

In der heutigen Folge von „Alles auf Aktien“ sprechen die Finanzjournalisten Nando Sommerfeldt und Philipp Vetter über enttäuschende Exporte, großes Lob für Adidas und ein offenbar bevorstehendes Rüstungs-IPO. Außerdem geht es um Wacker Chemie, Thyssenkrupp, De Nora, ITM Power, Plug Power, Nel ASA, Green Hydrogen Systems, Air Products, Linde, Baker Hughes, Doosan Fuel Cell, CIMC Enric, Inpex, IHI, Kawasaki Heavy Industries, Ceres Power Holdings, Bloom Energy, SFC Energy, den BNP Paribas Easy ECPI Global ESG Hydrogen (WKN: A3DDSN), den L&G Hydrogen Economy (A2QMAL), den Invesco Hydrogen Economy (A3DP7T), den VanEck Hydrogen Economy (A2QMWR) und den Global X Hydrogen (A3E40P). Wir freuen uns an Feedback über aaa@welt.de. Disclaimer: Die im Podcast besprochenen Aktien und Fonds stellen keine spezifischen Kauf- oder Anlage-Empfehlungen dar. Die Moderatoren und der Verlag haften nicht für etwaige Verluste, die aufgrund der Umsetzung der Gedanken oder Ideen entstehen. Für alle, die noch mehr wissen wollen: Holger Zschäpitz können Sie jede Woche im Finanz- und Wirtschaftspodcast "Deffner&Zschäpitz" hören. Impressum: https://www.welt.de/services/article7893735/Impressum.html Datenschutz: https://www.welt.de/services/article157550705/Datenschutzerklaerung-WELT-DIGITAL.html

In this episode, we start by talking about the Smith Maneuver which allows homeowners to make their mortgage interest payments tax deductible. Braden then goes over the parallels between investing and golfing. We finish the episode with stocks on our watchlist. Symbols of stocks discussed: AXON, IHI, TMO, DHR, SYK, MDT, BSX, EW Check out our portfolio by going to Jointci.com Our Website Canadian Investor Podcast Network Twitter: @cdn_investing Simon's twitter: @Fiat_Iceberg Braden's twitter: @BradoCapitalBuy us a coffee ☕️ ❤️: https://ko-fi.com/tcipodSee omnystudio.com/listener for privacy information.

On this episode of Highmark's Health Care Reinvented, learn how Highmark uses massive data sets to improve patient experience and outcomes while simultaneously managing data bias and the utmost security. We welcome Ian Blunt, VP of Advanced Analytics at Highmark Health, where his group form a center of expertise for all things data science and sophisticated analytical techniques. Leading a team of 100-plus data scientists, researchers and engineers, Blunt and his team are at the forefront of developing new capabilities for novel use cases, building predictive analytics and machine learning models, next best action selection, behavioral engineering, evaluation of interventions, analytics enablement, natural language processing, coordinating Highmark's analytic product portfolio and transitioning analytics to the cloud. At the end of the day, Blunt says all of the work comes down to directly improving the patient experience and proving health outcomes. Listen and learn how the human experience is expressed through the data! Transcription: All right, Audrey, we're gonna get just a little geeky today on healthcare reinvented because we have someone who is no stranger to the healthcare reinvented podcast rodeo, we have Ian Blunt hanging out with us today. Very excited because this guy, when it comes to all things, analytics, we want to talk to you. Because he always I think last time we talked to moderate our brains were like, ooh, like this. And now it's great to do a deep dive. So we're really excited. So do you want to? So Ian, why don't you just tell people a little bit about your background, and why you're such an expert on the topic that we're going to be talking about? Sure. I'm very excited to be here talking to you guys about it. So my name is Ian Blunt. I'm Vice President of advanced analytics for Highmark Health. So we form a center of expertise for all things data science and sophisticated analytic techniques within the organization, Highmark Health integrated health care organization. So we've got a health insurance arm, we've got a provider arm in the form of Allegheny Health Network, and we've got a few diversified businesses as well and my team kind of sit at the parent company and help each of the business units with the various use cases they've got to apply. And that's that I think techniques that every now and again, we did get to this really interesting thing, or blended health, where we're using information from both sides in a regulated way to improve the experience for all of our members and patients make it sound so simple, but healthcare is really complicated. That's one of the things that I think makes it such a rich territory for analytics. It's also been an industry that's kind of slow to adopt some of the analytic techniques, often for good reason, because of the magnitude of the decisions being made and security concerns around the data privacy, and what have you. But I think when you look at how high marks really trying to transform healthcare, it all comes down to I live in health strategy, which really is about making healthcare simple, making it personalized, and making it more proactive. And there's advanced analytics applications throughout that kind of mission statement. So what are the big things that you're working on? So like, what keeps you up at night, so that, you know, sort of set the table for us so we can understand because sometimes people are listening to this? And they're like, huh, how does that, you know, how does that really translate into meaningful experience and meaningful outcomes? There's so much going on. It's really exciting, again, kind of a factor of healthcare having been traditionally slow to adopt these techniques, and also the huge range of use cases that Highmark Health covers. So some really good examples, I think about how we can improve the efficiency but certain services work with so got a really nice technique that's operational within chemotherapy infusion facilities with within Allegheny Health Network. So traditionally, if you have cancer, new on chemotherapy drugs, you'll go to the infusion center, you'll sit in an infusion chair for variable length of time. And you'll do that several times over the course of your treatment. And traditionally about was just booked based on where the local administrators thought they could see a slot, what we are able to do is, first of all, build a model that predicts how long each infusion is actually going to take. So personalize it around the patient and the treatment that they're having. And then apply some optimization techniques. So we can optimize for schedule. That means we can fit each potential appointment in where there's a good slot for it. And one of the things we found is we were able to increase the utilization of each chair from about 55% of its time being occupied to bet 90% of its time being occupied, which is great, because these are saving for the provider, which means we can lower the cost of health care overall. And also, these are really valuable resources, potentially life saving. So we want to maximize the access to it as much as we can. There's also other fringe benefits. So when you're not, don't have that schedule optimized, some sessions over run, they just take longer than expected, which means the next patient, you know, getting frustrated there, whoever's, you know, often people using the service need a ride, so whoever's come to pick them up, is now hanging around, no need to be there and no idea what's going on. And also, when the whole system kind of comes a regular, you put a lot of pressure on your pharmacy that mix in these chemotherapy drugs, which of course, if they're under pressure, that increases the likelihood someone could make a mistake. So there's some potentially very serious outcomes there. So by smoothing that all out with providing a much more efficient use of the service which is lower cost with providing better outcomes, better experience for patients and providers, as well. So it's it's a real win for that kind of application of advanced analytic techniques. That's an interesting use case and thinking. I mean, it seems like so niche, you look at all the things that goes into healthcare, but how important is that, I mean, the idea that you can get more people into the chairs, so that way, they're able to get the treatment in a faster way. And then the ripple effects, not like the safety of like a pharmacist mixing something and not being rushed to mix up things so that you're making sure they're getting the right, the right treatments. That to me is is amazing having problems come to you to say we need to solve this, obviously, there were some issues around that. So they came to your team. And they're like, Wow, we need to solve this. How can we do it? So how does that process work? Yeah, so I'd say it's about 7030, the business coming to us with things they'd like to do, and 30% of us heading out with ideas solved. So I think also, the cool thing about the way we've implemented that chemotherapy infusion example is even though chemotherapy infusions niche, and we're going to scale to all of the infusion centers, and then that's kind of a limit there, you see that pattern repeated many times. So for example, operating rooms, again, variable length, important resource problems, if it was schedules, that's the sort of clog up and then dialysis appointments, even MRI. So there's lots of places where those same basic principles can be repeated, to achieve similar even better outcomes. And then, of course, the challenge we've got is well, how do we manage it all, there's far more demand for these services for analytic techniques than we can meet. So it's about a process of running backlogs of requests, prioritizing them based on value. Again, one of the things I really enjoy about working in healthcare is we talked about value in terms of stakeholder quintuple aim. So it's not just dollars and cents, although lowering costs is an important part of the going to play. But you've got how can we bet get better outcomes for the population, and you've got the clinical and patient experience very important factors. And just recently, the IHI who defined quintuple aim added increase in health equity to that as well. So that kind of changes nicely with a lot of the sort of community based organizations that Highmark works about works with, and how we think about equity and social needs alongside traditional healthcare needs. What about the issues like around security? Right? Like, can you talk about that, there's so much data, people get so worried and intimidated. And yet they really don't have all the facts in terms of, of how that data lives and how that data is protected? Yeah. Healthcare data, medical industry data is I think, most fiercely protected by the public. I've seen literature out there where people do surveys, and they are more interested in protecting privacy around health care than they are, for example, criminal records, or their tax records. So critically, critically important that we treat those data securely. And with respect, it's a huge privilege to get to work with this information. And part of executing on that privilege really is concepts within healthcare industry, we call minimum necessary. So we should only be sharing the minimum necessary data that we need to go and execute. And in my line of work, that typically means we don't need to see names and addresses, we need to see some of the demographic factors, we need to see the health history, but I don't need to know who that piece of information is associated with, I can do my job just as well, without knowing that. So that's another way that we keep it secure. And then the other challenge we've got is thinking about exchanging information within healthcare. So it's actually relatively a security people shout at me, it's relatively simple to create a completely walled garden where just nothing can get in, nothing can get out. And one of the things we need to do as a modern healthcare companies share information. So share with provider partners share with vendors provide healthcare solutions shared with all sorts of people. So it really is about being able to have those systems that facilitate rapid ability to move information to where it needs to be but also keep everything secure, to make sure that that information isn't going to go anywhere that it shouldn't be going and we've got a well matured data governance infrastructure that supports us in doing that and it comes all the more important is interoperability. Rose is a trend within the healthcare industry. We're not Talk in file transfers anymore. Now we've got people accessing through API's and other means we need to be able to adapt quickly, as needed. But also make sure we're doing it in a very measured, controlled and secure way. I was really curious to talk more about like how you're able to eliminate bias. And this as well, too, that's a lot that I've been hearing is obviously keeping it secure. But then, as you're gathering this data to make sure that you're not getting bias out of this, you can actually make decisions and things based upon real clean data, I guess, for lack of a better term.  Yeah. So that's a fascinating subject. And I think one that in general, is going to come into the sort of AI and analytics industry, it's already come in. So if we think about data security is what we can and can't do. There's a lot of law there. And then there's also the question of what we should and shouldn't do. And that's where I think data ethics really comes into play. Highmark really wants to establish itself as a thought leader on within the industry, it's very important to us personally, that the Insight we're generating is being used in an ethical way. And that covers lots of different applications, particularly around model bias, which has been a very hot topic for the last couple of years. And we've put a number of systems and processes in place to help guide our thinking around that, and also working with a number of partners as well to inform what we do. So to be very kind of like, high level on it, when we're ever we're considering sort of an AI based use case. The first thing we do is we think about the use case itself. So what before we do any modeling tall, even thinking about the data? What are the business asking us to do? You know, how might the data or how might that action, introduce some sort of bias? Is that even the right thing to be doing, and we can drive a conversation within the business on that? Then the next one, once we've accepted the use case, and we're working on it typically involves some level of predictive model. Within a predictive model, you can find a list of influential features, basically, what data elements drive in the model outputs? And depending on which algorithm you're using, sometimes you have to use simple explainers to get at that, but it gives us a really good sense of what's going on there. And then we check that back with our business colleagues. So we literally go down the list, is there anything problematic in that, that we're worried about? Is there anything that's proxy and something that might be problematic, and then the next step is really important. So it's not the sense that if it's in there, and problematic, we automatically take it out, we need to think about the impact it's having. There are some times when actually it's really important. For example, prevalence of diabetes is different depending on people's ethnicity. So there's a really good argument for having ethnicity based information within a diabetes model. And again, it's about the actual output, what happens differently in the real world because of what the models say. And so we think through those various use cases, take information out rebuild the model if we feel we need to. And then we do a series before it's elevated to production, we do assess what's called back tests. So essentially, we look at model performance over a range of different categories and get a good sense of, you know, is it performing particularly well on one category, but particularly poorly on another, and we use scores in that as well. So it's kind of typical check on what the model is performing. And then the last thing we do is we monitor the model's performance over time. So we're checking for drift so we can understand and be alerted to if anything, when we launched it production was unbiased, has now seems to become biased, for whatever reason, and we can dig in to that. So that's, that's our system, we go through that. We're very proud of it. I've got to say, we've not had too many cases where anyone's had to raise their hand and say, I think something's not quite right here, which is great. But I think it's important that we're always vigilant and always developing around some of this stuff as well. And I think one of the important things come in, just in general, like the trends in the latest legislation around AI ethics, and what have you, I think are going in a really good direction. We used to train people used to try to regulate specific use cases. And I think AI is going to become so pervasive, that doesn't really make any sense. What we need to think about is harms. So what's the harm of something being biased if I'm Netflix recommending a movie, versus what's the harm of saying biased if I'm offering a health care solution, but it is going to have a demonstrable impact on people's lives and the degree of scrutiny that you're applying to each application needs to flex based on Basically the risks that you're incurring by operating in that space. I know what I'm thinking. I'm wondering, what advice would you give to people who are in college or thinking about trying to have an impact, right? A lot of everyone's looking for? How do they have an impact? How do they make a difference? And, you know, people might not understand that, that this is another opportunity right there in terms of the work that you're doing, what guidance, what advice would you give people if they want to follow that kind of trajectory of career opportunities and in analytics. Oh, I would definitely say pick something you're passionate about. Because that, that kind of gives you that whole side. So I was talking a little bit about the data ethics piece, I mean, a lot of being able to spot what what might be problematic in the use case, or in inferential variable comes from having data scientists that are really engaged in healthcare. They're interested in the policy, their strategy, as well as the technical solutions. And there's kind of two models in general of doing data science. So one is, you kind of keep all your data scientists locked up in a dark room somewhere. And you've got this analytic consultant figure that goes between them and the business gathering requirements. It's fine, it's very transactional. But what we think is one that's not very satisfying for the data scientists. And two, it doesn't really give the optimal solution. So the data scientist will excellently solve the problem that set them, but we really miss them being in the room, around the table with the business, so they can actually help the business iterate on what the real problem we're trying to solve here is, and at Highmark, we definitely practice that partnership model, seeing our data scientists at the table, understanding the strategy helps the business understand the data in the analytics as well. So they trust it more. And ultimately, I think gets us much better solutions. And, I think, really phenomenal implementation rates. So one thing you see quoted quite a lot is data science projects, only like 30 to 40% of them make it to production. At Highmark, that number is much closer to 80, or 90. So we're really getting value out of this stuff. And to me, it's all about that partnership model. Now, that does create some challenges for us, because now we're looking out for not only data scientists with top notch technical skills, but we also need people that are interested in healthcare and strategy and can do the communication piece as well. But I'm proud to say like we've hired that throughout. And we've got a really fantastic team here, data scientists and research that physicians and analysts and data engineers and software engineers, strategy analysts, and product owners, who can all operate in that way. And I think that's one of the reasons we're so successful in just bringing this huge number of use cases to bear to transform healthcare. How many are in the team? Seems like you kind of quite the cruel obviously, that makes this happen. It's kind of exciting to lead a team like this. Yeah, we do. So we sit within the larger enterprise and data organized hate enterprise and data analytics organization. We specialize, as I say, in the sort of advanced analytics enter the market. So your data science sophisticated techniques, there's about 100 of us within the advanced analytics group. And that covers everything from big data analytics, machine learning and AI and natural language processing, but also out into what we in healthcare called core ideas, more commonly in industry, next best action, basically working out what someone's needs are, and then what the best way to meet that need is and then pushing that message into a workflow system so it can be actioned straightaway. We also do think about how we package that call to action as well. So using nudge techniques, a be testing to make sure when that call to action is out there for the next best action, it's more likely to be acted upon. And then we also do analytic evaluation analytics. So one of the things really important to us, is once we've triggered an action, we understand the benefit that both Highmark and the member and patient got out of that interaction. And we create this learning system so that the idea is tracked, does more of what we know works, and less of what doesn't. And we can also use our evaluation techniques to understand well, how might we improve our interventions to so we can get the results that we need or continuously improve the successful one. And on top of that, we're also managing kind of holding the ring for all of our analytics partners with transition from on prem technology into Google Cloud. What about Ian Blunt the man what is in do for fun? And what do you think about living on this side of the pond? Oh, so that's been a great big adventure. We moved over here in 2015. My wife grew up in Pittsburgh, which is how I landed here. Pittsburgh has always come back. That seems to be the rule. And it's been wonderful. We, even before we have kids, we agreed that we wanted them to both grow up spending time in both sides of the Atlantic. So it's been wonderful. Pittsburgh's a great city. It really is so much here to do so much. So easy to get around the Yeah, obviously, America is going through some interesting times. And I'm glad to be here. And part of seeing those changes go. I tell you what it's for so glad that you're here in Pittsburgh doing what you're doing, because this is the type of work that's really setting Pittsburgh apart. And to have that coming through. Highmark Health is just amazing. And every time we talk to you, Adrienne, I was like, Oh, my God, man, he gets to have a lot of fun, but he's got some serious responsibility on his shoulders. Oh, it's an awesome job. But to your point, like, the install of the states is watching Pittsburgh and healthcare. There's a lots of thoughts, but obviously, the US healthcare system has a fair amount of challenges. And the solution, one of the places it's likely to be born is in Pittsburgh. So Pittsburgh really has a national focus within the healthcare industry on what's going on here right now. So it's a super exciting place to be. We couldn't agree more, that's for sure. Yeah, it's so much fun talking to you. We're gonna have to have you back. Again, because we want it to be continually changes. There's always something new to update us with and so we really appreciate your time. Anytime glad to thank you. I love having these conversations because I get to hang out with you and for half an hour and learn about these things anyplace else. So too much fun. This has been Jonathan Kersting and this is Audrey Russo. Thank you so much. We're from the Pittsburgh tech Council. We love bringing you healthcare reinvented with iMovie Transcribed by https://otter.ai

Today's daf is sponsored by Savta Becki Goldstein in honor of her two eldest grandsons chayalim Eitan Efrayim and Gilad Yoel on their twentieth birthdays. "With gratitude to Hashem for the z'chut of reaching this milestone with them. Our wishes for briut and simcha and hatzlacha in their endeavors and may Hashem keep them safe and all our chayalim. Amen." A woman who was a nazir and separated animals for her sacrifice and then her husband nullified the vow, what happens to those animals? It depends on whether the money used to purchase the animals was her husband's money or her own. If it was his, the animals are no longer sanctified. If it was her own money, the one designated for the sin offering is left to die, the burnt and peace offerings are offered as voluntary offerings. But the peace offering has unique laws - it can only be eaten for one day, like the nazirite peace offering but is not eaten with loaves of unleavened bread that usually accompany the nazirite offering. If she had just designated money for the animals, all that money is used to purchase voluntary offerings. If she had designated money and specified what would be purchased with the money, the same concept applies as before - the money for the sin offering is sent to the Dead Sea as it cannot be used for anything, the money for the burnt and peace offerings are used to buy voluntary burnt and peace offerings as per the details in the earlier case. There is a debate between Rabbi Yehuda and the rabbis about whether a husband is obligated to pay for his wife's sacrifices by a commitment written in the ketuba. Which one of these opinions fits in with our Mishna regarding the husband who gave money to his wife for sacrifices? Two different versions are brought of a debate regarding this issue between Rav Chisda and Rava. What would be a scenario where she would have her own money to purchase the sacrifices? Avuha bar Ihi listed four cases in which a nazir peace offering is brought without the accompanying loaves. What are the four cases? Are there not more? What about a nazir sacrifice that was slaughtered incorrectly (either not for the sake of the right sacrifice or it was a an animal in its first year, instead of its second year of life.

Today's daf is sponsored by Savta Becki Goldstein in honor of her two eldest grandsons chayalim Eitan Efrayim and Gilad Yoel on their twentieth birthdays. "With gratitude to Hashem for the z'chut of reaching this milestone with them. Our wishes for briut and simcha and hatzlacha in their endeavors and may Hashem keep them safe and all our chayalim. Amen." A woman who was a nazir and separated animals for her sacrifice and then her husband nullified the vow, what happens to those animals? It depends on whether the money used to purchase the animals was her husband's money or her own. If it was his, the animals are no longer sanctified. If it was her own money, the one designated for the sin offering is left to die, the burnt and peace offerings are offered as voluntary offerings. But the peace offering has unique laws - it can only be eaten for one day, like the nazirite peace offering but is not eaten with loaves of unleavened bread that usually accompany the nazirite offering. If she had just designated money for the animals, all that money is used to purchase voluntary offerings. If she had designated money and specified what would be purchased with the money, the same concept applies as before - the money for the sin offering is sent to the Dead Sea as it cannot be used for anything, the money for the burnt and peace offerings are used to buy voluntary burnt and peace offerings as per the details in the earlier case. There is a debate between Rabbi Yehuda and the rabbis about whether a husband is obligated to pay for his wife's sacrifices by a commitment written in the ketuba. Which one of these opinions fits in with our Mishna regarding the husband who gave money to his wife for sacrifices? Two different versions are brought of a debate regarding this issue between Rav Chisda and Rava. What would be a scenario where she would have her own money to purchase the sacrifices? Avuha bar Ihi listed four cases in which a nazir peace offering is brought without the accompanying loaves. What are the four cases? Are there not more? What about a nazir sacrifice that was slaughtered incorrectly (either not for the sake of the right sacrifice or it was a an animal in its first year, instead of its second year of life.

We're wrapping up our Advance Care Plan Series in collaboration with the amazing team from The Conversation Project from IHI, sharing the lessons we learned during our advance care planning process.  Creating an advance care plan is not an easy task, even if you're not in the middle of a serious illness.  Family dynamics have a big influence on how conversations about end of life happen.  We learned it's important to set aside a quiet time and place to talk with the ones you want to make your wishes known when you can't speak for yourself.  There were emotional impacts to the advance care planning conversations as well.  Maybe it was awareness of our own mortality, or the recognition that we might not get the time we want with kids and grandkids.  There was even some concern that no one in the family feels like a good fit to be a healthcare proxy.  As healthcare providers, we gained a new perspective on patients' and caregivers' experience with end of life planning.  Maybe everyone who works in end of life care should gain this valuable insight into what our patients go through to make their wishes known.  Check out The Conversation Project website here. Get resources to get your conversation started here. Follow TCP on Facebook here. Connect with TCP on Twitter here. Find more information about hospice philosophy, end of life care, and self care for both personal and professional caregivers here.  Find more podcast episodes from The Heart of Hospice at The Heart of Hospice Podcast (theheartofhospice.com) Connect with podcast host Helen Bauer at helen@theheartofhospice.com. Book podcast host Helen Bauer to speak at your event or conference by sending an email to helen@theheartofhospice.com.    

Welcome to the second episode of our Advance Care Plan Series in partnership with The Conversation Project, featuring TCP's Improvement Advisor for Community Engagement and Learning Patty Webster!  Whether you want to have ACP conversations in a group of 5 of 500, The Conversation Project has the resources to get those discussions started.  Through shared stories on TCP's website, users can find examples of how other community groups are utilizing TCP's resources.  There's a Starter Guide to take to your group, and other tools and resources to help you all available for free.  You'll find guidance on hosting an ACP event, tips for promoting your message and engaging your community, and ways to network with others. Bring those all-important end of life conversations with your group! Connect with The Conversation Project at theconversationproject.org Find TCP's community resources here.  Follow The Conversation Project on social media: Facebook - TheConversationProject Instagram - Convo Project Book podcast host Helen Bauer to speak at your event or conference by sending an email to helen@theheartofhospice.com.   Find more podcast episodes from The Heart of Hospice at The Heart of Hospice Podcast (theheartofhospice.com) Connect with podcast host Helen Bauer at helen@theheartofhospice.com.  

Peter Lachman M.D. MPH. M.B.B.Ch., FRCPCH, FCP (SA), FRCPI was Chief Executive Officer of the International Society for Quality in Healthcare (ISQua) from 1st May 2016 to 30th April 2021. He has great experience as a clinician and leader in quality improvement and patient safety. He led the transformation of ISQua to be one of the leading global organisations in quality, safety and person centred care.Dr Lachman was a Health Foundation Quality Improvement Fellow at IHI in 2005-2006 and developed the quality improvement programme at Great Ormond Street Hospital where he was the Deputy Medical Director with the lead for Patient Safety. He was also a Consultant Paediatrician at the Royal Free Hospital in London specialising in the challenge of long term conditions for children. Dr Lachman has been the National Clinical Lead for SAFE, a Heath Foundation funded RCPCH programme which aims to improve situation awareness in clinical teams across England.Currently, he is Lead Faculty Quality Improvement at the Royal College of Physicians of Ireland (RCPI) in Dublin, where he directs the Leadership and Quality programme to develop clinical leaders in quality improvement. He is co-founder and Chairperson of PIPSQC, the Paediatric International Patient Safety and Quality Community.Get a copy of the Handbook of Patient Safety

 Kirk B. Jensen, MD, MBA, FACEP, has spent over 20 years in Emergency Medicine management and clinical care. Board-certified in Emergency Medicine, he has been medical director for several emergency departments and is Chief Medical Officer for Best Practices, Inc. Dr. Jensen is a faculty member for the Institute for Healthcare Improvement (IHI) focusing on quality improvement, patient satisfaction, and patient flow both within the ED and throughout the hospital. He chaired two IHI communities, Improving Flow Through the Acute Care Setting and Operational and Clinical Improvement in the Emergency Department. Currently he is a leader of the innovative IHI seminars Cracking the Code to Hospital-wide Patient Flow and Perfecting Emergency Department Operations. Dr. Jensen is a popular speaker and coach for EDs across the country. He is co-author of two books, Leadership for Smooth Patient Flow (2007 ACHE Hamilton Award winner) and Hardwiring Flow. He is the recipient of the 2007-08 American College of Emergency Physicians (ACEP) Honorable Mention Speaker of the Year Award. Dr Jensen presents on patient safety, patient flow, operations management, and change management at the ACEP Emergency Department Directors Academy. In addition, Dr. Jensen served on the expert panel and site examination team of Urgent Matters, a Robert Wood Johnson Foundation Initiative focusing on helping hospitals eliminate ED crowding and congestion as well as preserving the health care safety net. Dr. Jensen holds a Bachelor s Degree in biology from the University of Illinois (Champaign) and a Medical Degree from the University of Illinois (Chicago). He completed a residency in Emergency Medicine at the University of Chicago Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3 (https://www.surveymonkey.com/r/3DXCFW3) CME credit is available for up to 3 years after the stated release date Contact CEOD@bmhcc.org if you have any questions about claiming credit.

In 2010  Ellen Dunham Jones gave a TedTalk on retrofitting the suburbs and repurposing malls. In 2021, Kedar Mate et al authored a piece in Harvard Business Review Why Health Care Systems Should Invest in Medical Malls Kedar Mate, MD, is the President and Chief Executive Officer at the Institute for Healthcare Improvement (IHI), President of the Lucian Leape Institute, and a member of the faculty at Weill Cornell Medical College. Dr. Mate's scholarly work has focused on health system design, health care quality, strategies for achieving large-scale change, and approaches to improving value. Previously Dr. Mate worked at Partners In Health, the World Health Organization, Brigham and Women's Hospital, and served as IHI's Chief Innovation and Education Officer.  Dr. Mate has published numerous peer-reviewed articles, book chapters and white papers and has received multiple honors including serving as a Soros Fellow, Fulbright Specialist, Zetema Panelist, and an Aspen Institute Health Innovators Fellow. He graduated from Brown University with a degree in American History and from Harvard Medical School with a medical degree.  You can follow him on twitter at @KedarMate Ian Sinnett, AIA, ACHA, is a Principal and board-certified healthcare architect who co-leads the Dallas Health Practice for Perkins&Will. His expertise is concentrated on the strategic, pre-design, programming, and planning phases of projects furthered by a continued level of intensity and project engagement through completion and first-patient. Ian has worked with a range of for-profit, developer, rural, academic, and not-for-profit clients including MD Anderson Cancer Center, HCA, UT Southwestern, Children's Health, Penn Medicine, Legacy Community Health, and RedBird Dallas. Notable recent projects include critical access hospitals in Uvalde, TX and Pecos, TX, a complete reconfiguration and expansion of the Lancaster General Health ED (15th busiest in the US), and acting as the Principal in Charge of the RedBird Mall Sears Dark Store revitalization with UT Southwestern and Children's Health in Southern Dallas. Outside of his professional life, Ian travels the world with his wife, is a volunteer and advocate for Big Brothers Big Sisters, and is building his dream get-a-away in the high deserts of West Texas.

Dr. Thom Mayer has been widely recognized as one the nation's foremost experts in leadership, management, and customer service in healthcare. His skills as a speaker are legendary, and are attested to by the fact that he was named Outstanding Speaker of the Year for the American College of Emergency Physicians in the second year of the award, and has twice been given the Over the Top; Award, which is given to the highest rated speaker of the year for the American College of Emergency Physicians. Dr. Mayer has given Keynote speeches at numerous national conferences, including those for The Studer Group. Dr. Mayer has published over 60 articles, 60 book chapters, and has edited ten textbooks on healthcare leadership, customer service, and emergency medicine. Dr. Mayer wrote Leadership for Great Customer Service, about which leadership guru Tom Peters said, 'I honestly can t remember when I ve seen so much of so much importance crammed into a short book. This book is laser-like in its aim'; Most recently, Dr. Mayer wrote Leadership for Smooth Patient Flow. The Emergency Department and Hospitalists services for which he is responsible have won awards from virtually every survey company in healthcare, including one client whose scores rose from the first percentile to the 85th percentile in one year. On September 11, 2001, Dr. Mayer served as one of the Command Physicians at the Pentagon Rescue Operation, coordinating all medical assets at the site. In addition, physicians under his direction were the first to successfully diagnose and treat inhalation anthrax victims during the fall 2001 anthrax crises in the nation s capital. Dr. Mayer also serves as the Medical Director of the NFL Player s Association. Insightful lessons and anecdotes from all of these experiences are woven into his presentations. Without exception, client audiences have raved about Dr. Mayer s presentations, citing their warmth, wisdom, and extremely humorous presentation. Dr. Mayer s passion and energy in speaking about customer service and leadership in healthcare have resulted in valuable lessons and practical applications. Kirk B. Jensen, MD, MBA, FACEP, has spent over 20 years in Emergency Medicine management and clinical care. Board-certified in Emergency Medicine, he has been medical director for several emergency departments and is Chief Medical Officer for BestPractices, Inc. Dr. Jensen is a faculty member for the Institute for Healthcare Improvement (IHI) focusing on quality improvement, patient satisfaction, and patient flow both within the ED and throughout the hospital. He chaired two IHI communities; Improving Flow Through the Acute Care Setting and Operational and Clinical Improvement in the Emergency Department. Currently he is a leader of the innovative IHI seminars Cracking the Code to Hospital-wide Patient Flow and Perfecting Emergency Department Operations. Dr. Jensen is a popular speaker and coach for EDs across the country. He is co-author of two books, Leadership for Smooth Patient Flow (2007 ACHE Hamilton Award winner) and Hardwiring Flow. He is the recipient of the 2007-08 American College of Emergency Physicians (ACEP) Honorable Mention Speaker of the Year Award. Dr Jensen presents on patient safety, patient flow, operations management, and change management at the ACEP Emergency Department Directors Academy. In addition, Dr. Jensen served on the expert panel and site examination team of Urgent Matters, a Robert Wood Johnson Foundation Initiative focusing on helping hospitals eliminate ED crowding and congestion as well as preserving the health care safety net. Dr. Jensen holds a Bachelor s Degree in biology from the University of Illinois (Champaign) and a Medical Degree from the University of Illinois (Chicago). He completed a residency in Emergency Medicine at the University of Chicago Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3...

News: Researchers run a gas turbine on pure hydrogen in world first | New Atlas (01:51) Gas turbines are found in aircraft, trains, ships, generators, pumps, compressors and all sorts of other places. 90% currently run on natural gas, which  produces carbon dioxide when you burn it In the race to zero emissions by 2050, several organizations, including General Electric, have been looking into transitioning gas turbines to burn green hydrogen as a clean fuel source.As of now, GE has more than 100 turbines running on at least 5 percent hydrogen fuel by volume, and they say they are on the path to 100 percent. Researchers at the University of Stavinger in Norway say they've beaten everyone to the punch, claiming that they've had a 100 percent hydrogen-burning gas turbine running since mid-May this year.Runs its own micro gas power plant, and its gas turbine produces heat, electricity and hot water for hydronic heating. Professor Mohsen Assadi, leader of the research team, states:“We have set a world record in hydrogen combustion in micro gas turbines. No one has been able to produce at this level before … The efficiency of running the gas turbine with hydrogen will be somewhat less. The big gain though, is to be able to utilize the infrastructure that already exists.” Eventually, these kinds of projects will lead to conversion kits that can keep old turbine equipment alive while moving it to zero-emissions fuel sources.But this process needs to become economically viable, which means the price of green hydrogen needs to come down substantially.   First successful treatment of severe pulmonary hypertension with umbilical cord stem cells | MedicalXPress (05:27) Clinical researchers at Hannover Medical School (MHH) have succeeded for the first time in stopping the usually fatal course of pulmonary hypertension thanks to a novel therapeutic approach. Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. Pulmonary arterial hypertension (PAH), blood vessels in the lungs are narrowed, blocked or destroyed. In some people, pulmonary hypertension slowly gets worse and can be life-threatening. A three-year-old girl suffering from so-called pulmonary arterial hypertension (PAH) was treated a total of five times with mesenchymal stem cell products obtained from a human umbilical cord. The researchers' analysis showed that the products of the stem cells from the umbilical cord were able to improve regeneration in the damaged blood vessels, inhibit inflammation of the blood vessels and curb damage to certain parts of the cells. Professor Dr. Georg Hansmann, head of the Translational Cardiopulmonary Biomedicine research group, talked on the treatment's success:“The treatment led to a significant improvement in growth, exercise tolerance and clinical cardiovascular variables and reduced the number of plasma markers in the blood that can be detected in vascular constriction and inflammation." After six months, not only was there a clear improvement in health, but there were also no undesirable side effects.First time there is a therapy for people suffering from pronounced forms of pulmonary hypertension The team assumes that such a therapy must be repeated at regular intervals in order to be successful long term, in the case of chronically progressive, often therapy-resistant pulmonary arterial hypertension (PAH). Japan Is Dropping a Gargantuan Turbine Into The Ocean to Harness 'Limitless' Energy | ScienceAlert (08:53) Japanese engineers have constructed a true leviathan, a beast capable of withstanding the strongest of ocean currents to transform its flow into a virtually limitless supply of electricity.IHI Corporation – has been tinkering with the technology for over a decade now, partnering with New Energy and Industrial Technology Development Organization (NEDO) in 2017 to put their designs to the test. In February, the project passed a major milestone with the completion of a successful three-and-a-half year field test in the waters off Japan's southwestern coast. Prototype called Kairyu330 tons 20 meter (66 foot) long fuselage flanked by a pair of similar-sized cylinders Housing a power generation system attached to an 11 meter long turbine blade. The device can orient itself to find the most efficient position to generate power from the push of a deep-water current, and channel it into a grid. IHI estimates that if the energy present in the current could be harnessed, it could feasibly generate around 205 gigawatts of electricity, an amount it claims is in the same ballpark as the country's current power generation.Enormous amount of potential in the ocean's tumultuous movements Kairyu was designed to hover roughly 50 meters below the waves – as it floats towards the surface, the drag created provides the necessary torque on the turbines. The turbine blades rotate in an opposing direction keeping the device relatively stable. Churning out a total of 100 kilowatts of power. With demonstrated success at withstanding what nature can throw at it, Kairyu could soon have a monster sibling swinging 20-meter-long turbines to generate a more respectable 2 megawatts.I covered another tidal turbine The Orbital 02 developed a Scottish Engineering Company back in episode 55 that was able to generate 2 MW of power.   Woman receives 3D-printed ear made from her own cells | The Verge (12:23) Around 1,500 babies born in the United States each year have microtia, a condition where one or both ears are underdeveloped or missing entirely.  A regenerative medicine company, 3DBio Therapeutic, announced in a press release doctors successfully transplanted a 3D-printed ear made from human cells onto a woman born with the rare ear deformity microtia. Part of the first clinical trial of the technology, Marks a major step forward for tissue engineering. 3DBio Therapeutics has an ongoing clinical trial with 11 participants testing its AuriNovo ear, a personalized tissue implant to replace the missing ear in these patients.This experimental process involves taking a biopsy from the patient's existing ear and pulling out cartilage cells. Those cells are then grown and 3D printed into the shape of the patient's ear. The ear keeps regenerating cartilage over patients' lifetimes, and because it is made from their own cells, it's less likely to be rejected. Executives from 3DBio Therapeutics told The New York Times they thought their technology could potentially print other body parts like noses and rotator cuffs and, eventually, complex organs like livers and kidneys.Ears are simpler than organs and, unlike livers, aren't necessary to keep people alive, so it'll be a long road toward that potential future.   NASA assembles a UFO research team to study ‘unidentified aerial phenomena' | TechCrunch (16:22) NASA has announced the formation of a study team dedicated to UFOs — or unidentified aerial phenomena (UAPs) Starting this fall, the study will have researchers identify what UAP data already exists, determine how best to collect UAP data moving forward and develop methods to study the nature of UAPs, for both scientific and aerospace defense reasons. Part of the team will be Daniel Evans, the assistant deputy associate administrator for research at NASA's Science Mission Directorate, who stated:“Over the decades, NASA has answered the call to tackle some of the most perplexing mysteries we know of, and this is no different … I do want to underscore that NASA is uniquely positioned to address UAPs, because who other than us can use the power of data and science to look at what's happening in our skies? And quite frankly, this is why we do what we do.” This isn't the first program dedicated to UAP research:1952 and 1969, the United States Air Force (USAF) studied UAPs under Project Blue Book.  In 2017, The New York Times revealed a Pentagon UAP research program called the Advanced Aerospace Threat Identification Program (AATIP), which ended in 2012 due to lack of funding.  NASA will not be seeking to develop explanations for UAPs, extraterrestrial or otherwiseThis is more of an information-gathering mission — one whose results will be shared publicly, unlike many findings of the DoD — that may open the door for further UAP research and analysis.  

Donald M. Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement, is also former Administrator of the Centers for Medicare & Medicaid Services. A pediatrician by background, Dr. Berwick has served on the faculty of the Harvard Medical School and Harvard School of Public Health, and on the staffs of Boston's Children's Hospital Medical Center, Massachusetts General Hospital, and the Brigham and Women's Hospital. He has also served as Vice Chair of the US Preventive Services Task Force, the first "Independent Member" of the American Hospital Association Board of Trustees, and Chair of the National Advisory Council of the Agency for Healthcare Research and Quality. He served two terms on the Institute of Medicine's (IOM's) Governing Council, was a member of the IOM's Global Health Board, and served on President Clinton's Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. Recognized as a leading authority on health care quality and improvement, Dr. Berwick has received numerous awards for his contributions. In 2005, he was appointed "Honorary Knight Commander of the British Empire" by Her Majesty, Queen Elizabeth II in recognition of his work with the British National Health Service. Dr. Berwick is the author or co-author of over 160 scientific articles and six books. He currently serves as Lecturer in the Department of Health Care Policy at Harvard Medical School. Follow Don on Twitter Nana Twum-Danso, MD, MPH, FACPM, ​Senior Vice President, Global, Institute for Healthcare Improvement (IHI), leads all global strategy and client development, with top-line revenue responsibility. Previously she was Managing Director for Health at The Rockefeller Foundation, overseeing a strategy designed to transform the practice of public health through data science. She is a public health and preventive medicine physician with 20 years of experience in health policy, practice, strategy, monitoring, learning, evaluation, research, and philanthropy at local, national, and international levels. Dr. Twum-Danso is also an Adjunct Assistant Professor in the Department of Maternal and Child Health at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill. She worked at the Task Force for Global Health in Atlanta, Georgia; was Director of IHI's nationwide CQI initiative in Ghana; Senior Program Officer in the MNCH Department at the Bill & Melinda Gates Foundation; independent consultant; and Founder and CEO of MAZA, a social enterprise that provided on-demand health care transportation for pregnant women and sick infants in remote areas of Ghana. She also served on technical advisory committees for the World Health Organization, the US National Academy of Sciences, Engineering and Medicine, and the Canadian International Development Research Centre. Dr. Twum-Danso received her undergraduate and medical education from Harvard University and her public health and preventive medicine residency training from Emory University.  Follow Nana on Twitter.

BALDIN in the mix: 01. Mann ft. 50 Cent - Buzzin (Remix) 02. Lakeyah, OG Parker ft. Tyga, DJ Drama - In 03. Mark Ronson ft. Ghostface Killah, Nate Dog - Oh Wee 04. Bruno Mars - 24K Magic 05. Tyga x Akon - Bouncing On My Dick (Bass King Blend) 06. Afro Bros, Ghetto Flow - Boomerang 07. Moreart ft. IHI - Я буду е***ь 08. Panjabi MC - Mundian to Bach Ke 09. Budsworth x Beyonce - Single Ladies (Lebedeff Blend) 10. Puri x Mc Zaac, Anitta, Tyga - Desce Pro Play (DJ Yella Blend) 11. Beyonce - Crazy in love (Soulboss Soulbounce Edit) 12. Kali Uchis x BBNOS - Telepatia (Danny Diggz Remix) 13. Tyga, Megan Thee Stallion - FREAK 14. Doja Cat - Woman with love to VAV & MF DISTARK in the mix: 01. HANZO 陰陽 - VIOLET SAPPHIRE 02. YL & Take_Five - Pulsar 03. Kuuro - BTFU (ft. AnthonyZ) 04. Gydra - Frostbolt 05. Teddy Killerz - Panic Attack 06. Lost Heroes & Tommygunnz - Break (ft. N.E.B.) 07. Vanilla Ace - Commotion (Ricky Remedy Edit) 08. Alternative Kasual - The Switch 09. Eptic & MARAUDA -Wall Of Death 10. M4HIR - Solo 11. CCX - ASS ON LAMP 12. Valentino Khan & Dillon Francis - Move It 13. WE ARE FURY - Crown (ft. Brassie & Kyle Reynolds) 14. Bear Grillz & Kompany - Red Alert

Drs. Farley and Shah recently spearheaded a collaboration with leaders from the AMA, AHA, CEO Coalition, Dr. Lorna Breen Foundation, IHI, and National Academy of Medicine (NAM) to create the 2022 Healthcare Workforce Rescue Package. The package was devised to help leaders zero in on the most impactful team member well-being efforts to undertake at the current stage of the pandemic. In this episode, we delve into each of the five practices outlined in the Rescue Package and look ahead to how these create a foundation for a transformed culture of well-being for all healthcare team members. Links related to Dr. Farley and Dr. Shah's podcast: · Resources: The 2022 Healthcare Workforce Rescue Package · Schwartz Center Webinar: Five Evidence-Based Actions Leaders Can Take Now to Support the Healthcare Workforce · National Academy of Medicine: Clinician Well-Being Resource Library

As the International Hospitality Institute recognizes and celebrates Hospitality Excellence through the Global Hospitality Awards, we thought it fitting to revisit our conversation with Dr. Jeffrey Obomeghie, President and CEO of the International Hospitality Institute, The Global Advocacy, Training and Standards Organization for the Hospitality Industry.  We discuss all things hospitality to include what we have learned over the past 18 months, the future of hospitality and bridging the gap between Gen Z, millennials and hospitality veterans. About Dr. Jeffery Obomeghie: Dr. Jeffrey O is a seasoned CEO, hospitality educator, internationally renowned coach and author. He currently serves as President of the International Hospitality Institute where he oversees IHI's global operations.  www.Internationalhospitalityinstitute.com https://www.instagram.com/intl_hosp_inst FOLLOW US: IG:   https://www.instagram.com/dontlookunderthebedpod Facebook: https://m.facebook.com/dlutbpod  https://www.linkedin.com/in/nikiwade  niki@dontlookunderthebed.org  https://www.linkedin.com/in/robinmoncrieffe robin@dontlookunderthebed.org Learn more about your ad choices. Visit megaphone.fm/adchoices